{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T06:08:38Z","timestamp":1779170918765,"version":"3.51.4"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    Tuberous sclerosis complex (TSC) is an autosomal dominant genetic and multi-spectrum disease, characterized by the development of benign hamartomas in multiple organ systems, which may be misdiagnosed as malignant neoplasms. We present the case of a TSC patient with a large ovarian endometrioma that showed heterogeneous enhancement on a computerized tomography (CT) scan, and Tc-99\u202fm-methylene diphosphonate (\n                    <jats:sup>99m<\/jats:sup>\n                    Tc-MDP) bone scintigraphy revealed the possibility of bone metastases. She was initially misdiagnosed with a malignant ovarian tumor and multiple metastases, whereas the definitive diagnosis was established based on clinical diagnostic criteria related to TSC. Following multidisciplinary management, our patient\u2019s general condition remains satisfactory. We aim to enhance the understanding of TSC by summarizing the clinical manifestations and imaging findings of our patient in order to reduce the rates of missed and misdiagnosed cases.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1819173","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T05:40:24Z","timestamp":1779169224000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Tuberous sclerosis complex with ovarian endometrioma misdiagnosed as multiple metastases: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Hao","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Neurology, Affiliated Hospital of North Sichuan Medical College, North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Medical Rehabilitation, The Second Clinical College of North Sichuan Medical College, Nanchong Central Hospital","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pengyu","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Affiliated Hospital of North Sichuan Medical College, North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Affiliated Hospital of North Sichuan Medical College, North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Affiliated Hospital of North Sichuan Medical College, North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Affiliated Hospital of North Sichuan Medical College, North Sichuan Medical College","place":["Nanchong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"16035","DOI":"10.1038\/nrdp.2016.35","article-title":"Tuberous sclerosis complex","volume":"2","author":"Henske","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"ref2","doi-asserted-by":"publisher","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":"ref3","doi-asserted-by":"publisher","first-page":"1538","DOI":"10.1002\/ajmg.a.37644","article-title":"Do patients with tuberous sclerosis complex have an increased risk for malignancies?","volume":"170","author":"Peron","year":"2016","journal-title":"Am J Med Genet A"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12881-015-0155-4","article-title":"Targeted next generation sequencing reveals previously unidentified Tsc1 and Tsc2 mutations","volume":"16","author":"Nellist","year":"2015","journal-title":"BMC Med Genet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e1005637","DOI":"10.1371\/journal.pgen.1005637","article-title":"Mosaic and intronic mutations in Tsc1\/Tsc2 explain the majority of Tsc patients with no mutation identified by conventional testing","volume":"11","author":"Tyburczy","year":"2015","journal-title":"PLoS 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Imaging"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1111\/j.1440-1673.1996.tb00352.x","article-title":"Bone changes in tuberous sclerosis mimicking metastases","volume":"40","author":"Pui","year":"1996","journal-title":"Australas Radiol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e35659","DOI":"10.7759\/cureus.35659","article-title":"Difficulties in differentiating Osteosclerosis in patients with multifocal micronodular Pneumocyte hyperplasia and Cancer","volume":"15","author":"Kumamoto","year":"2023","journal-title":"Cureus"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e444","DOI":"10.1097\/rlu.0000000000000855","article-title":"Accurate characterization of skeletal lesions in tuberous sclerosis complex using 99mtc Mdp Spect\/Ct","volume":"40","author":"Parida","year":"2015","journal-title":"Clin Nucl 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