Germline and somatic inactivating mutations in the putative tumor-suppressor gene ARMC5 (armadillo repeat containing 5)- a member of the armadillo/β-catenin-like repeat superfamily- can cause primary bilateral macronodular adrenal hyperplasia (a rare form of primary adrenal Cushing syndrome) (49, 50). Here, ARMC5 is linked to Macronodular adrenal hyperplasia.