Dermatological and endocrine elements in Carney complex (Review)

Sandru,Florica; Dumitrascu,Mihai Cristian; Petca,Aida; Carsote,Mara; Petca,Razvan-Cosmin; Paun,Diana Loreta

doi:10.3892/etm.2021.10748

Dermatological and endocrine elements in Carney complex (Review)

Authors:
- Florica Sandru
- Mihai Cristian Dumitrascu
- Aida Petca
- Mara Carsote
- Razvan-Cosmin Petca
- Diana Loreta Paun
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Affiliations: Department of Dermatology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of Endocrinology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of Urology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
Published online on: September 17, 2021 https://doi.org/10.3892/etm.2021.10748
Article Number: 1313

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Abstract

Carney complex (CΝC) is a very rare, autosomal dominant, hereditary syndrome. Seventy percent of individuals with CNC have germline inactivating or deleting mutations of the CNC1 gene [currently known as protein kinase cAMP‑dependent type I regulatory subunit α (PRKAR1A), located at the 17q22‑24 chromosome level], with 30% of cases presenting with phosphodiesterase gene mutations. A member of the lentiginosis family, dermatological features include: skin pigmentation, cutaneous/mucosal myxomas, usually diagnosed by the age of 20 years (neonatal presentation is exceptional, requiring a meticulous differential diagnosis). Melanocyte‑derived tumors such as epithelioid blue nevi (with different levels of pigmentation) and pigmented epithelioid melanocytoma (previously ‘animal‑type melanoma’) are often found. Myxomas, mesenchymal tumors with mostly a benign pattern, may be recurrent. Primary cutaneous melanotic schwannoma are atypical, while non‑skin sites are frequent. Corticotropinomas or somatotropinomas are part of the hereditary syndrome‑related pituitary adenomas (representing 5% of all). Primary pigmented nodular adrenocortical disease involves bilateral cortical hyperplasia causing Cushing syndrome (CS) at an earlier age than non‑CNC cases; osteoporotic fractures seem more prevalent compare to CS of other etiologies. Typically benign, a few cases of adrenocortical carcinoma have been identified. A total of 5% of familial non‑medullary thyroid cancer is syndromic, also including CNC. CNC‑related thyroid frame includes: hyperthyroidism, follicular hyperplasia/adenomas, follicular carcinoma (usually aggressive, bilateral or multifocal). Large cell calcifying Sertoli cell tumors of the testes have malignant behavior in adults; in children these may induce precocious puberty. Two particular mammary tumors are found: myxoid fibroadenomas and breast myxomatosis. Cutaneous/subcutaneous lesions, pigmented or not, or any focal swelling of non‑identified cause needs careful examination, since dermatological elements are among the earliest and most discernable by which to detect lesions in CNC, a systemic condition with multi‑level endocrine involvement.

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