POMC and adrenal gland hyperfunction: Among PitNETs, a rare subset known as silent corticotroph adenomas (SCAs) produces adrenocorticotropic hormone (ACTH) without causing clinical signs of hypercortisolism.7 SCAs account for approximately 3%–6% of all PitNETs and about 5.5% of nonfunctioning PitNETs.8,9 Typically, SCAs are confirmed postoperatively through histopathological analysis, with immunohistochemical testing showing positive staining for ACTH or the pituitary-restricted T-box transcription factor (T-PIT), which helps distinguish SCAs from other nonfunctional PitNETs.10