PMC7363700_01
A: Multiple angiofibromas over forehead, and cheeks. B: Well defined hyper pigmented plaques of sizes measuring 12 x 10 cm seen over the posterior aspect of trunk suggestive of shagreen patches. C: Multiple periungual fibromas noted on the nails of both upper limbs Fig. 1D: Oral cavity examination revealed dental pits (Black arrow head).
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Clinical examination revealed multiple angiofibromas over the forehead, and cheeks (Fig. 1A). There were two well defined hyperpigmented plaques of sizes measuring 10 x 5cm and 12 x 10 cm over the left lower abdomen and posterior aspect of trunk suggestive of shagreen patches (Fig. 1B). Multiple periungual fibromas were also noted on the nails of both upper limbs (Fig. 1C). Oropharyngeal examination revealed dental pits (Fig. 1D).
Noncontract Computed tomography (NCCT) scan of the brain showed multiple calcified subcortical nodules (yellow arrowhead) and left lateral ventricle lesion (Black arrowhead).
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Fig. 2) and left lateral ventricle lesion (black arrowhead, Fig. 2). For a better characterization of the lesion, the MRI brain was done, which revealed a heterogenous contrast-enhancing lesion in the left lateral ventricle.
MRI brain showed a heterogeneous contrast enhancing lesion in the left lateral ventricle, hyperintense on FLAIR sequences suggestive of giant cell astrocytoma.
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The lesion was hypointense on T1, T2 sequences, and hyperintense on FLAIR sequences, suggestive of giant cell astrocytoma (Fig. 3).
Contrast-enhanced CT chest revealed the presence of subcentimetric thin walled cystic lesions in the lungs (Black arrowhead), pneumomediastinum, and right sided pneumothorax and diffuse subcutaneous emphysema.
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Contrast-enhanced CT chest revealed the presence of subcentimetric thin-walled cystic lesions in the lungs (black arrowhead, Fig. 4), pneumomediastinum, right sided pneumothorax, and diffuse subcutaneous emphysema (Fig. 4).
CECT abdomens showed well defined heterogeneously enhancing lesions in the right kidney suggestive of angiomyolipoma.
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CECT abdomens showed well defined heterogeneously enhancing lesions in the right kidney suggestive of angiomyolipoma (Fig. 5).