<prompt> A 35-year-old woman presents with fatigue, weakness, and weight gain. Her blood pressure is 15590 mm Hg, pulse 80min, and there is central obesity with skin striae. Investigations are shown in Table given below. Which of the following is the most likely diagnosis?Table given below is the case work-up NormalPatientPlasma ACTH pgmL 150 50Plasma cortisol mdL1735Urine 17-OH mg24 h2 to 1025Urine 17-Ks mg24 h5 to 1510Urine 17-OH response to:ACTH IVIncreasex5No responseDexamethasone 0.5 mg 3.0No response2.0 mg 3.0No responseMetyrapone 750 mgIncreasex 2No responseAbbreviation: ACTH--adrenocorticotropic hormoneadrenal hyperplasia secondary to hypothalamic dysfunctionadrenal adenoma with complete autonomyexogenous steroids, iatrogenicpituitary tumor  <response>: Autonomous adrenal tumors are adrenocorticotropic hormone ACTH insensitive and fail to demonstrate a brisk rise in urinary 17-hydroxycorticoids. Androgenic effects, such as hirsutism, are usually absent. In Cushings syndrome, secondary to an autonomous adrenal tumor, onset is usually gradual, and hirsutism, other androgenic effects, and hyperpigmentation are absent. 