Recurrent Multifocal Cardiac Myxomas With Multiterritorial Embolization: Unmasking Carney Complex

Carney complex (CNC) is a rare autosomal dominant tumor-predisposition syndrome characterized by cardiac myxomas, cutaneous pigmentation, and endocrine abnormalities.

A 19-year-old woman presented with acute ischemic stroke. She had previously undergone resection of a left atrial myxoma complicated by severe postoperative morbidity and subsequently developed recurrent myxoma and another embolic stroke. Multimodality imaging identified recurrent left ventricular myxoma and inferolateral myocardial infarction, considered embolic. CNC was diagnosed clinically based on recurrent myxomas, lentiginosis, and a first-degree relative with cardiac myxoma. More than 20 tumors were surgically removed with complete macroscopic resection, with no recurrence at 3 months.

This case highlights the cardiac manifestations and embolic potential of CNC and the value of multimodality imaging, individualized surgical decision-making, and lifelong multidisciplinary surveillance.

Recurrent or ventricular myxomas in young patients should prompt evaluation for CNC, particularly with lentiginosis or a family history. Multimodality imaging defines cardiac involvement and detects silent embolic complications, supporting lifelong surveillance and family counseling.