Bilateral non-adrenal malignancies (metastasis, adrenal lymphoma [149]) may lead to adrenal insufficiency due to neoplastic infiltration of the adrenal glands: in selected cases, especially if imaging is not conclusive for lipid-rich AI and ACTH levels are increased, an insufficient cortisol secretion should be reasonably suspected. The gene discussed is POMC; the disease is Adrenal insufficiency.