Endocrine Abstracts

Carney complex (CNC) is rare autosomal dominant disorder, which was firstly described as a combination of manifestation of myxomas, spotty skin pigmentation and endocrine overactivity in 1985. This condition affects many organs and varies in clinical manifestation. The presence of at least two clinical signs is considered as pathognomonic with regard to a sporadic form of CNC, and an evidence of at least one sign with simultaneous manifestation of CNC in any of first degree relatives is considered as pathognomonic with regard to a familiar form. Intracardiac and extracardiac myxomas are the most common diagnostic signs. In our report, we present a case of 36-year male patient with history of surgery for testicular Sertoli – cell tumour and surgery of thyroid nodule, with diagnosis of acromegaly. The patient was examined for persistence of hypersomatotropism after partial resection of growth hormone secreting pituitary adenoma, followed by radiation treatment with Leksell γ knife and treated by somatostatin analogues. Recently, as a part of differential diagnosis procedure aiming to discover other increased endocrine activity, we consider potential occurrence of intermittent hypercortisolism based on primary pigmented nodular adrenocortical disease. As a part of comprehensive examination of associated complications of acromegaly we added echocardiography with findings of intra-cardiac tumours. Drifting thrombus, or bacterial flora, or myxomas were considered as options in differential diagnosis. Patient underwent urgent surgical excision of myxomas in left and right atrium at Cardiac Surgery Clinic. The diagnosis of Carney complex was confirmed by genetic testing.