Identification of a PRKAR1A mutation (c.491_492delTG) in familial cardiac myxoma: A case report

Medicine (Baltimore). 2019 Mar;98(11):e14866. doi: 10.1097/MD.0000000000014866.

Abstract

Rationale: Cardiac myxoma is the most common cardiac neoplasm. Currently, there are not many reports on familial cardiac myxoma. Herein, we reported 2 first-degree relatives with left atrial myxoma.

Patient concerns: A 20-year-old female was admitted in our hospital for lapsing into a coma for 24 hours, and was diagnosed with recurrent left atrial cardiac myxoma. The patient's father also had a history of cardiac myxoma.

Diagnosis: The patient was diagnosed with left atrial myxoma using transthoracic echocardiography (TTE). Whole exome sequencing (WES) identified a p.Val164Aspfs (c.491-492delTG) mutation in the cAMP-dependent protein kinase A (PKA) regulatory (R) subunit 1 (PRKAR1A) gene for both the proband and her father, but not in her uncle and brother, who had not shown manifestation of cardiac myxoma by the time of this report.

Interventions: The myxoma resection was performed following the standard procedure of open chest surgery.

Outcomes: The tumor was successfully removed along with the tuberculum. The patient recovered well and was discharged home. No recurrence occurred during 1-year follow-up.

Lessons: Our findings suggest that PRKAR1A mutation (c.491_492delTG) may be associated with cardiac myxoma, and genetic counseling and specific locus mutation tests may contribute to assessing the risk of cardiac myxoma.

Publication types

  • Case Reports

MeSH terms

  • Cyclic AMP-Dependent Protein Kinase RIalpha Subunit / analysis*
  • Cyclic AMP-Dependent Protein Kinase RIalpha Subunit / blood
  • Cyclic AMP-Dependent Protein Kinase RIalpha Subunit / genetics*
  • Cyclic AMP-Dependent Protein Kinases / analysis
  • Cyclic AMP-Dependent Protein Kinases / blood
  • Echocardiography / methods
  • Family Characteristics
  • Female
  • Genetic Counseling / methods
  • Humans
  • Myxoma / blood
  • Myxoma / genetics*
  • Myxoma / surgery
  • Young Adult

Substances

  • Cyclic AMP-Dependent Protein Kinase RIalpha Subunit
  • PRKAR1A protein, human
  • Cyclic AMP-Dependent Protein Kinases