Tuberous sclerosis presenting as bilateral flank masses in an infant

Value of sonography in the workup of patients with tuberous sclerosis

“…1 In that paper, a patient was found to have bilateral cystic kidneys on sonography and was later diagnosed as having tuberous sclerosis (TS) by skin biopsy. We agree fully that sonography is an extremely useful tool in the workup of these patients.…”

“…Those authors recommend sonography every 5 years for all patients with TS and annually if an abnormality is detected. The polycystic form of renal involvement, described in the article by Wheeler et al, 1 frequently has its presentation in infancy or early childhood and can usually be managed conservatively. Another, less common form, is multiple hamartomatous changes with cysts and small angiomyolipomas; this form may be associated with a higher risk of renal impairment and has been postulated to have genetic implications of a ''double hit.''…”