Imaging-based diagnosis of late-onset tuberous sclerosis complex presenting with acute renal hemorrhage

Tuberous sclerosis complex (TSC) is a rare multisystem genetic disorder characterized by hamartomatous lesions affecting multiple organs, most commonly the brain, kidneys, skin, heart, and lungs. Although typically diagnosed in childhood, late-onset presentations may occur, particularly when renal manifestations predominate. We report the case of a 64-year-old patient admitted for gross hematuria with acute kidney injury, in whom imaging findings strongly suggested previously undiagnosed TSC.