POMC and adrenal gland hyperfunction: Initial hormonal evaluation confirmed ACTH – dependent hypercortisolemia with morning cortisol level of 1185 nmol per liter (normal range, 166 to 507 nmol per liter) and evening cortisol (2300 h) of 771.4 nmol per liter (normal range, 73.8 to 291 nmol per liter), in the presence of high normal ACTH level (44.97 pg per milliliter [normal range, 10.0 to 60.0 pg per milliliter]).