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Familiar Myxoma with a Positive Genetic Test - A case report -

유전자 검사에서 양성 반응을 보인 가족성 점액종 - 1예 보고 -

  • Lee, Hyang-Lim (Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Hospital) ;
  • Park, Kook-Yang (Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Hospital) ;
  • Kim, Kyung-Hee (Department of Laboratory Medicine, Gachon University Gil Hospital) ;
  • Lee, Seung-Tae (Department of Laboratory Medicine and Genetics, Samsung Medical Center) ;
  • Ki, Chang-Seok (Department of Laboratory Medicine and Genetics, Samsung Medical Center) ;
  • Jeon, Yang-Bin (Gachon Medical School, Gil Hospital, Heart Center) ;
  • Choi, Chang-Hyu (Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Hospital)
  • 이향림 (가천의과학대학교 길병원 흉부외과) ;
  • 박국양 (가천의과학대학교 길병원 흉부외과) ;
  • 김경희 (가천의과학대학교 길병원 진단검사의학과) ;
  • 이승태 (삼성의료원 진단검사의학과) ;
  • 기창석 (삼성의료원 진단검사의학과) ;
  • 전양빈 (가천의과학대학교 길병원 심장센터) ;
  • 최창휴 (가천의과학대학교 길병원 흉부외과)
  • Received : 2009.07.24
  • Accepted : 2009.09.28
  • Published : 2010.02.05

Abstract

Ten percent of all myxomas are the familial form. Familial myxomas appear to have autosomal dominant transmission. We experienced two siblings with familial myxomas. A left atrial myxoma was surgically removed in a 21-year-old woman. Six years later, other myxomas were found in the right atrium and the left atrium and these were also surgically removed. Right ventricular and right atrial myxomas were surgically excised in her brother. The two siblings were found to have frame-shift mutations in the PRKAR1A gene (c.537delA; p.Gly180GlufsX26), which is the causative gene for Carney complex. Obtaining the genetic diagnosis makes it possible to prepare more effective therapeutic strategies for these patients and the gene carriers. Complete excision, ruling out multicentricity and proper postoperative follow up are all necessary to avoid recurrence of myxoma.

전체 심장 점액종의 10% 정도가 가족성이며 상염색체 우성 유전을 보인다. 저자들은 21세에 좌심방 점액종 제거술을 받고 6년 후에 우심방과 좌심방에 점액종이 재발한 여자 환자와 26세에 우심실과 우심방에 점액종이 발생하여 제거술을 받은 남동생에서 가족성 점액종의 원인이 되는 PRKAR1A 유전자의 돌연변이(c.537delA; p.Gly180GlufsX26)를 확인하였다. 유전자 검사를 통한 가족성 점액종의 진단은 효과적인 치료계획을 세우는데 도움이 된다. 가족성 점액종의 경우 처음부터 다발성으로 존재할 가능성과 잦은 재발을 고려하여 수술 시 종양의 완전 절제와 수술 후 재발에 대한 추적검사가 필수적이다.

Keywords

References

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