POMC and cancer: ACTH levels and the ratio DHEA-S to the lower limit of normal (DHEA-S-to-LLN) did not differ among the different groups at baseline, but ACTH levels tended to be lower in patients without any second neoplasm or second malignancy at follow-up (with any second neoplasm ACTH: 20.75 (5–97.9) pg/mL; without any second neoplasm ACTH:16.75 (4.52–65.3) pg/mL, p = 0.05; with second malignant neoplasm ACTH: 23.6 (5–97.9) pg/mL; and without second malignant neoplasm ACTH:17.1 (4.52–65.3) pg/mL, p < 0.05).