Endogenous Cushing’s syndrome, which is often diagnosed with a significant delay (mean delay to diagnosis: 34 months) occurs due to the excessive production of endogenous glucocorticoids, usually as the result of tumours, mostly pituitary adenomas, that produce adrenocorticotropic hormone (ACTH), then overstimulating the adrenal glands to produce cortisol4. Here, POMC is linked to Cushing syndrome due to macronodular adrenal hyperplasia.