Cushing syndrome: Uncovering carney complex due to novel PRKAR1a mutation

Catherine D. Zhang, Pavel N. Pichurin, Aleh Bobr, Melanie L. Lyden, William Francis Young, Irina Bancos

Research output: Contribution to journalArticle

Abstract

Carney complex (CNC) is a rare multiple neoplasia syndrome characterized by spotty pigmentation of the skin and mucosa in association with various non-endocrine and endocrine tumors, including primary pigmented nodular adrenocortical disease (PPNAD). A 20-year-old woman was referred for suspected Cushing syndrome. She had signs of cortisol excess as well as skin lentigines on physical examination. Biochemical investigation was suggestive of corticotropin (ACTH)- independent Cushing syndrome. Unenhanced computed tomography scan of the abdomen did not reveal an obvious adrenal mass. She subsequently underwent bilateral laparoscopic adrenalectomy, and histopathology was consistent with PPNAD. Genetic testing revealed a novel frameshift pathogenic variant c.488delC/p.Thr163MetfsX2 (ClinVar Variation ID: 424516) in the PRKAR1A gene, consistent with clinical suspicion for CNC. Evaluation for other clinical features of the complex was unrevealing. We present a case of PPNAD-associated Cushing syndrome leading to the diagnosis of CNC due to a novel PRKAR1A pathogenic variant.

Original languageEnglish (US)
Article number18-0150
JournalEndocrinology, Diabetes and Metabolism Case Reports
Volume2019
Issue number1
DOIs
StatePublished - Jan 1 2019

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Carney Complex
Cushing Syndrome
Adrenocorticotropic Hormone
Mutation
Lentigo
Skin Pigmentation
Adrenalectomy
Genetic Testing
Abdomen
Physical Examination
Hydrocortisone
Neoplasms
Mucous Membrane
Tomography
Skin
Genes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Cushing syndrome : Uncovering carney complex due to novel PRKAR1a mutation. / Zhang, Catherine D.; Pichurin, Pavel N.; Bobr, Aleh; Lyden, Melanie L.; Young, William Francis; Bancos, Irina.

In: Endocrinology, Diabetes and Metabolism Case Reports, Vol. 2019, No. 1, 18-0150, 01.01.2019.

Research output: Contribution to journalArticle

Zhang, Catherine D. ; Pichurin, Pavel N. ; Bobr, Aleh ; Lyden, Melanie L. ; Young, William Francis ; Bancos, Irina. / Cushing syndrome : Uncovering carney complex due to novel PRKAR1a mutation. In: Endocrinology, Diabetes and Metabolism Case Reports. 2019 ; Vol. 2019, No. 1.
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