POMC and Cowden syndrome 1: Adrenocorticotropic hormone independent CS (AICS) accounted for about 20% of CS cases, including unilateral adrenal adenoma or carcinoma, bilateral macronodular adrenal hyperplasia, bilateral micronodular adrenal hyperplasia, primary pigmented nodular adrenocortical disease, McCune-Albright syndrome, and bilateral adrenal adenomas or carcinomas.