PRKAR1A and Cowden disease: Based on his personal history of multiple cancers, a pituitary adenoma, multiple pigmented skin lesions, multiple lipomas, and multiple colon polyps with varying histology, the patient underwent genetic testing for Cowden syndrome (the PTEN gene), Carney complex (the PRKAR1A gene), and multiple endocrine neoplasia syndrome type 1 (the MEN1 or menin gene).