Figure 1: Pedigree of the family. The arrow identifies the index patient (II-2). Squares denote male family members, circles female family members, and a diagonal line a deceased member. Primary pigmented nodular adrenocortical disease with mutation of regulatory subunit R1A of protein kinase A gene and overt Cushing’s syndrome. Carrier of gene mutation of regulatory subunit R1A of protein kinase A gene in latent stage of Cushing’s syndrome. Unknown for Cushing’s syndrome or gene mutation. ? No Cushing’s syndrome and no gene mutation