{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:10:10Z","timestamp":1756275010777,"version":"3.44.0"},"reference-count":6,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,4,26]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>Tuberous sclerosis complex (TSC) is a rare genetic disorder characterised by benign tumours in multiple organs, with potential complications in the reproductive system. The author reports a case of a nulliparous woman in her mid-30s with a history of TSC and prior radical nephrectomy for renal angiomyolipoma. She presented with a history of heavy menstrual bleeding, dysmenorrhoea and lower abdominal pain. Imaging studies were suggestive of a large ruptured haemorrhagic ovarian cyst with the presence of blood in the uterine cavity. Laparoscopy-guided biopsy was performed by a gastrointestinal surgeon due to extensive adhesions. Intraoperative findings included a friable mass adherent to the pouch of Douglas and dense ovarian adhesions. Postoperative recovery was uneventful, and the patient was put on hormonal therapy. This case highlights the complex interplay of TSC-related pathology with gynaecological emergencies, emphasising the role of multidisciplinary management.<\/jats:p>","DOI":"10.1136\/bcr-2025-265601","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T22:30:12Z","timestamp":1746484212000},"page":"e265601","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Tuberous sclerosis complex and gynaecological complications: navigating diagnostic and surgical challenges"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9310-8464","authenticated-orcid":false,"given":"Vaishnavi","family":"Rajaraman","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, Government Medical College Hospital Kottayam, Kottayam, Kerala, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sobha S","family":"Nair","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Amrita Institute of Medical Sciences and Research Centre, Kochi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bribin","family":"Bright","sequence":"additional","affiliation":[{"name":"Radiology, Amrita Institute of Medical Sciences and Research Centre, Kochi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,5,5]]},"reference":[{"key":"2025082622380866000_18.5.e265601.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2013.08.001"},{"key":"2025082622380866000_18.5.e265601.2","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1186\/s12920-024-01913-8","article-title":"Malignant tumors in tuberous sclerosis complex: a case report and review of the literature","volume":"17","author":"Liu","year":"2024","journal-title":"BMC Med Genomics"},{"key":"2025082622380866000_18.5.e265601.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)64440-0"},{"key":"2025082622380866000_18.5.e265601.4","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1186\/s13023-021-01917-y","article-title":"Rare manifestations and malignancies in tuberous sclerosis complex: findings from the TuberOus SClerosis registry to increAse disease awareness (TOSCA)","volume":"16","author":"Sauter","year":"2021","journal-title":"Orphanet J Rare Dis"},{"key":"2025082622380866000_18.5.e265601.5","doi-asserted-by":"crossref","first-page":"798983","DOI":"10.3389\/frph.2022.798983","article-title":"Expanding Our Knowledge of Menstrual Irregularities Reported by Females With Tuberous Sclerosis Complex","volume":"4","author":"Mowrey","year":"2022","journal-title":"Front Reprod Health"},{"key":"2025082622380866000_18.5.e265601.6","unstructured":"RSilverstone L , Mahsoub M , Walizai T , et al . Tuberous sclerosis. Reference Article, RadiopaediaOrg; 2025. Available: https:\/\/radiopaedia.org\/articles\/tuberous-sclerosis?lang=us"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-265601","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:38:13Z","timestamp":1756273093000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-265601"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":6,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,5]]},"published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1136\/bcr-2025-265601"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-265601","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,5]]}}}