Emerging data on MACS and adrenal CS have highlighted a correlation between preoperative hypercortisolism severity, assessed through 1 mg-DST, and longer PH duration as well as the degree of preoperative hypothalamic–pituitary–adrenal (HPA) axis suppression, evaluated with baseline ACTH levels [16, 17]. Here, POMC is linked to adrenal gland hyperfunction.