Tuberous sclerosis

Discussion:

This case is known for tuberous sclerosis on antiepileptic treatment presented for follow up. Cortical tubers and subependymal nodules are noted. White matter changes are also noted, manifested with multiple subcortical white matter hypodensities and a cystic lesion (cystoid degeneration). Small subependymal nodules with calcifications at both lateral ventricles mostly representing subependymal hamartomas.

Bilateral subependymal lesion at the frontal horn of the lateral ventricles larger than 1 cm with calcifications, could suggest the possibility of being subependymal giant cell astrocytomas. They are benign tumors, seen almost exclusively in young patients with tuberous sclerosis. They classically appear as an intraventricular mass near the foramen of Monro.

The bilateral renal heterogeneous hyperechoic lesions are suggestive of bilateral small angiomyolipomas. Renal manifestations of tuberous sclerosis include renal angiomyolipoma(s)renal cystsrenal cell carcinoma, and oncocytomas.

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