Early Recurrence of Cardiac Myxomas in an Adolescent With Carney Complex: Clinical Clues Preceding Imaging Findings-A Case Report.

Background: Carney complex is a rare autosomal dominant syndrome characterized by multiple cardiac myxomas with early onset and high recurrence rates, associated with a significant risk of intracardiac obstruction and embolic events. Case Presentation: A female patient was diagnosed at age 14 with multiple intracardiac masses involving both atria and the right ventricle, which were confirmed as myxomas and surgically resected. She also presented with mucocutaneous lentiginosis and a pituitary microadenoma, establishing a clinical diagnosis of Carney complex despite negative genetic testing. During follow-up, new masses were initially interpreted as intracardiac thrombi and treated with anticoagulation but were subsequently reclassified as tumor recurrence based on multimodal imaging. Progressive tumor burden led to a second surgical intervention with complete resection of multicameral lesions, with favorable clinical evolution. Conclusion: This case illustrates the systemic and recurrent nature of Carney complex and highlights the critical role of cardiac magnetic resonance imaging in differentiating thrombus from tumor, optimizing therapeutic decision-making, and avoiding unnecessary interventions.