Abstract

Carney Complex (CNC) is a rare autosomal dominant syndrome characterized by skin pigmentation abnormalities, endocrine tumors, and cardiac myxomas. This report presents an 11-year-old girl with a history of pontine glioma treated with chemotherapy and radiotherapy at 2.5 years of age, who presented with complaints of weight gain and short stature, along with syndromic features (multiple nevi around the mouth and nose, four café-au-lait spots, and bilateral clinodactyly of the fourth toes) identified during physical examination. Genetic testing revealed a novel pathogenic PRKAR1A variant, confirming the diagnosis of CNC. The patient was diagnosed with Cushing’s syndrome due to unsuppressed cortisol levels observed in a high-dose dexamethasone suppression test. Pathological evaluation following unilateral adrenalectomy confirmed the presence of primary pigmented nodular adrenocortical disease (PPNAD). This case highlights the importance of recognizing the atypical course of CNC to prevent delays in diagnosis and treatment.