Malignant psammomatous melanotic schwannoma in a patient with Carney complex associated with a novel variant in the PRKAR1A gene.

Carney complex (CNC) is an autosomal dominant multiple neoplasm syndrome, characterized by the presence of endocrine and non-endocrine tumors; it includes myxomas, lentigines and primary pigmented nodular adrenocortical disease, among other signs/symptoms. In CNC type 1, inactivating mutations of the PRKAR1A gene were identified as the main cause of the disease, although since 2015 variants in other genes, including PRKACA and PRKACB, have also been linked to this pathology. PKA is an enzyme involved in the G protein-coupled intracellular pathways and serves as a mediator of c-AMP actions that promote cell metabolism, proliferation and apoptosis. The penetrance of CNC due to pathogenic variants in the PRKAR1A gene is close to 100%. We present the case of a 33-year-old female patient with cutaneous and mucosal lentiginosis, blue nevus, malignant melanocytic psammomatous schwannoma, cutaneous myxoma and a novel variant in the PRKAR1A gene.