CYP11B1 and congenital primary aphakia: Zhang et al have reported a case of bilateral adenomas that secrete cortisol and aldosterone, respectively,[8] while some researchers observed diffuse staining of CYP11B1 in adenoma lesions, and high CYP11B2 expression in the adjacent adrenal cortex.[9] Studies have pointed out that about 10% of PA patients have A/CPA,[7,10,11] and in PA patients with a single adenoma, the prevalence of A/CPA is 9.7 to 21%.[5,12] However, misdiagnosis often occurs because of the absence of clinical manifestations of overt cortisol levels increase in patients.