Tuberous sclerosis surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: José Eduardo Riceto Loyola Junior, M.D.[2]

Surgical options have been historically the only way to treat the TSC-associated complications, but with the introduction of the mTOR inhibitors they have been left for more severe or refractory complications.

• Vagal nerve stimulation or surgical resection of CNS lesion responsible for the epilepsy may be used.^[1]

• Treatment is done in a pre-emptive manner to prevent bleeding, reduce tumor size or slow its growth. Percutaneous embolization (which may present with postembolization syndrome) and nephron-sparing surgical resection are possible treatments.^[1]

• Surgical resection is the most performed treatment, but may complicate with incomplete resection, hemorrhage, infection and cerebrospinal fluid obstruction.^[1]

For TSC-associated skin lesions, the following surgical treatments may be performed:

• Ablation with pulse laser dye or CO2;
• Surgery