POMC and Cowden syndrome 1: CS was caused by Cushing’s disease (pituitary adenoma) in 7 patients, a unilateral adrenal adenoma in 2 patients, bilateral adrenal hyperplasia in 1 patient, and ACTH-dependent hypercortisolism of unknown origin (invisible pituitary adenoma or ectopic ACTH production of unknown origin) in 1 other patient.