The co-presence of ACTH-independent hypercortisolism in Cushing’s syndrome, which can be assessed through the evaluation of ACTH and morning cortisol, 24 h urinary cortisol, and a 1 mg dexamethasone suppression test, supports the hypothesis of adrenal hyperandrogenism. Here, POMC is linked to Cushing syndrome due to macronodular adrenal hyperplasia.