pigmented nodular adrenocortical disease, primary, 4 (MONDO_0014359) is any primary pigmented nodular adrenocortical disease in which the cause of the disease is a mutation in the PRKACA gene. Also known as: Cushing syndrome, ACTH-independent adrenal, somatic, PRKACA primary pigmented nodular adrenocortical disease, pigmented nodular adrenocortical disease, primary, type 4, primary pigmented nodular adrenocortical disease caused by mutation in PRKACA.