Indeed, mitotane can induce or aggravate preexisting hypercholesterolemia or hypertriglyceridemia through HMG-CoA-reductase activation and a retrospective analysis on a large patient cohort indicated an increase of HDL-cholesterol levels of approximately 60% independent from treatment with lipid-lowering drugs (6). This evidence concerns the gene HMGCR and Hypercholesterolemia.