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Case of the Week #509

Prasad Salunkhe

Affiliation: Pooja Research Institute of Women and Child health Care Pvt Ltd,Koregaon Satara, Maharashtra, India

Posting Dates: November 21, 2019 - December 5, 2019

Case report: This patient came to our hospital at 35 weeks of pregnancy. Previous familial history is noncontributory. Our ultrasound examination at 35 weeks revealed the following anomalies:

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Answer

We present a case of tuberous sclerosis.

Our ultrasound examination revealed the following findings:

  • Images 1, 2 and video 1: Intracardiac masses (rhabdomyomas)
  • Images 3, 4 and video 2-4: large left renal fossa mass (angiomyolipoma) and normal appearance of brain parenchyma.

The mother was examined. She was under treatment for chronic epilepsy and on exam was found to have adenoma sebauceum (Image 8). Ultrasound of the maternal kidneys revealed bilateral angiomyolipomas and a simple cyst (Image 9-11). Based on the maternal and fetal findings, the diagnosis was consistent with tuberous sclerosis.

A (8)
Image 8: Mother shows signs of adenoma sebaceum on exam.

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Image 9: Ultrasound of the maternal kidneys.
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Image 10: Ultrasound of the maternal kidneys.
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Image 11: Ultrasound of the maternal kidneys.

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