Figure 1.

The spectrum of manifestations seen in our patient with tuberous sclerosis (TSC)-associated renal-cell cancer. (A) MRI of the brain with gadolinium contrast showing numerous nonspecific FLAIR/T2 hyperintense lesions involving the cerebral hemispheres bilaterally with predominant involvement of the cortical gray matter without associated vasogenic edema, enhancement, or restricted diffusion consistent with TSC; (B) CT scan of the abdomen showing RCC forming multiple masses in the left kidney; (C) metastatic para-aortic adenopathy alongside cysts seen in the right kidney; (D) angiomyolipomas seen in the right kidney alongside several cysts; (E) angiomyolipoma seen in the right kidney; and (F) subcentimeter nodules seen in the lung consistent with metastases from RCC.