Because aggressive treatments such as surgical intervention or chemotherapy for ACTH-producing recurrent malignant metastatic PCC were not performed because of the growing tumor size (Fig. 1 E), adhesions into surrounding organs, possible rupture risk, and poor general performance status with pulmonary edema (Fig. 1 F), the patient gradually became sick and was re-admitted to our hospital this year. The gene discussed is POMC; the disease is neoplasm.