Atypical and voluminous skin manifestation of Bourneville tuberous sclerosis: A case report of giant scalp hamartoma

Bourneville tuberous sclerosis (BTS) is an autosomal dominant phakomatosis characterised by multisystemic involvement, particularly of the skin. Although facial angiofibromas are the most common lesions, severe or atypical forms affecting the scalp are rare. We report the case of a 26-year-old female patient presenting with a giant, highly progressive lesion of the scalp associated with BTS. The gradual increase in volume, the tumour-like appearance, and the major aesthetic impact prompted surgical intervention. Extensive excision followed by appropriate reconstruction was performed with good aesthetic and functional results. This case illustrates the value of plastic surgery in the management of severe and unusual cutaneous forms of tuberous sclerosis complex. It highlights the importance of reconstructive surgery in advanced forms of TSC.