I'll take a stab: it means that either (a) the CEO has ego problems and refuses to allow other C-suite titles, or (b) the CEO has failed to hire the appropriate

I'll take a stab: it means that either (a) the CEO has ego problems and refuses to allow other C-suite titles, or (b) the CEO has failed to hire the appropriate talent for a true CTO role (often because they're trying to do too much themselves).