POMC and Adrenal insufficiency: The initial hormonal evaluation was suggestive of secondary adrenal insufficiency, which was subsequently confirmed by an ACTH stimulation test while another pituitary axis was preserved. MRI pituitary revealed globular pituitary enlargement, for which they were taken off Pembrolizumab and began treatment with physiologic doses of steroid replacement (hydrocortisone 10 mg a.m. and 5 mg p.m.)and thyroid replacement for primary hypothyroidism as per standard clinical practice.