Significantly reduced expression of dehydroepiandrosterone sulfotransferase in surgically removed attached non-neoplastic adrenal tissues in patients with subclinical CS and adrenal CS was described (11, 21), which was considered to represent the degree of suppression of the hypothalamus–pituitary–adrenal (HPA) axis. Here, SULT2A1 is linked to Cowden syndrome 1.