Carney Complex

Review
In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000.
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Excerpt

Carney complex (CNC) is a rare dominantly inherited syndrome of multiple neoplasias combined with cardio-cutaneous manifestations. Approximately 70% of index cases have a familial history, while the remaining 30% have a de novo germline mutation. Hitherto, two loci have been principally involved in the genetics of CNC: the CNC1 gene, located on 17q22-24, which is coding the regulatory subunit (R1a) of the protein kinase A (PRKAR1A) and is responsible for 2/3 of cases, whereas the putative “CNC2” gene at the 2p16 locus has not been identified as yet. As most of the identified PRKAR1A mutations are nonsense and lead to a lack of detectable mutant protein, no genotype-phenotype correlations are generally observed. Cutaneous lesions (lentigines, nevi, and myxomas), although with minimal clinical impact, are the most common and occasionally specific findings, assisting early diagnosis. Cardiac myxomas show an atypical presentation and contribute substantially to mortality. Among several associated endocrine neoplasias, Primary Pigmented Nodular Adrenal Dysplasia is the one most frequently observed, followed by thyroid nodules, somatomammotrope adenomas, and testicular tumors. The diagnosis is principally set by 12 major clinical criteria and 2 supplemental criteria, including molecular testing and family history. Molecular testing, which has a mutation detection rate of approximately 60%, cannot currently be recommended for all patients. If testing is performed and a mutation is detected, genetic screening is recommended for first-degree relatives. Surveillance for all the manifestations of CNC should be performed at least annually, starting in infancy. As CNC is generated by a constitutional genetic defect, no etiologic therapy is available yet. The therapeutic approach should target each clinical manifestation and treat accordingly. For complete coverage of all related areas of Endocrinology, please visit our on-line FREE web-text, WWW.ENDOTEXT.ORG.

Publication types

  • Review