RFLNA (refilin A) is a filamin-binding protein that regulates the perinuclear actin network and nuclear shape, playing an essential role in actin cytoskeleton organization during skeletal development. 1 The protein functions by interacting with filamins to form perinuclear actin caps, which are critical structures that modulate nuclear morphology during cell migration and differentiation. 1 At the molecular level, RFLNA participates in actin filament bundle organization and is involved in negative regulation of chondrocyte development and bone mineralization. 1 Recent studies indicate RFLNA also regulates cytoskeletal dynamics in cancer cell adhesion and migration pathways. 2 Clinically, RFLNA mutations cause spondylocarpotarsal synostosis syndrome (SCT), a rare skeletal disorder characterized by vertebral fusion, short stature, and carpal/tarsal synostosis. 1 A homozygous frameshift mutation (c.241delC) in RFLNA was identified in an SCT patient with typical phenotype, establishing RFLNA as a causative gene for this condition alongside FLNB and MYH3. 1 Additionally, RFLNA expression patterns correlate with cancer survival disparities and prognosis in kidney renal clear cell carcinoma, suggesting potential therapeutic relevance in oncology. 34 RFLNA variants also influence body size determination in equine populations through cis-regulatory mechanisms. 5