POMC and neoplasm: By reviewing the natural history and behavior in our cohort of patients with CD submitted to BADX, we confirmed the global incidence of CTP-BADX/NS previously reported in other studies; moreover, we highlighted the importance of post-operative ACTH monitoring, identifying ACTH increase after BADX as a major risk factor for tumor re-growth; in addition, a greater ACTH response to CRH stimulation test and a blunt response to desmopressin test at CD diagnosis could to be linked to an increased risk of CTP-BADX/NS development.