POMC and Cushing syndrome due to macronodular adrenal hyperplasia: Approximately 50% of patients with thymic carcinoid have endocrine disorders, most of which is Cushing’s syndrome due to ectopic ACTH production or multiple endocrine neoplasia syndrome, specifically Type-1 multiple endocrine neoplasia.[11] Patients with ACTH ectopic syndrome often express moon-shaped faces, central obesity, livid striae, hypokalemia with amyosthenia, hypertension, and hyperlipidemia.