A 38-year-old woman presents with progressive proximal muscle weakness, easy bruising, and amenorrhea for 6 months. Clinical examination reveals central obesity, purple striae, and hypertension (160/95 mmHg). Laboratory investigations show elevated 24-hour urinary free cortisol and suppressed ACTH. Which of the following is NOT a typical feature of adrenocorticotropic hormone (ACTH)-independent Cushing syndrome?

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