Focal gigantism in tuberous sclerosis

A 38 year lady had recurrent generalized and myoclonic seizures since 6 years of age. On examination she had facial adenoma sebaceum and periungal fibromas, cutaneous angiofibromas on the back. Contrast enhanced magnetic Resonance Imaging of brain was suggestive of multiple cortical tubers with sub ependymal nodules consistent with the diagnosis of Tuberous sclerosis. Focal hypertrophy of the skin of the dorsal aspect of the left hand with focal gigantism was noted.