A case report showed that a patient with subclinical CS and ACTH-independent macronodular adrenal hyperplasia (AIMAH) underwent AVS and the result indicated no lateralization using criteria stated by Young et al. A left adrenalectomy was performed, and the patient improved clinically after the surgery (the left mass was larger than the right mass) (16). The gene discussed is POMC; the disease is Macronodular adrenal hyperplasia.