case_images: PMC11306133_01
case_images: Clinical manifestations of the patient. (A) Facial angiofibromas; (B) Multiple toenail fibromas; (C) Fibromas in the oral cavity; (D) "Shark skin" lies on the left lower back.
case_images: fcvm-11-1391775-g001.jpg
case_images: PMC11306133_01_fcvm-11-1391775-g001.jpg
case_images: F1
case_images: Symmetrically distributed pinpoint to millet-sized red papules were observed on the patient's face, particularly centered around the nose (Figure 1A). The tumors had smooth surfaces and were firm in texture (Figure 1B). There was mild cyanosis of the lips, significant gingival hyperplasia covering two-thirds of the dental crowns, increased spacing between teeth, and a slight malocclusion with fibrous papules present inside the oral cavity (Figure 1C). On the left side of the lumbar region, a papule measuring 2 cm x 2 cm was visible (Figure 1D).
case_images: Imaging and pathology results. (A) Several solid nodules in both lungs, with the largest one located in the anterior segment of the right upper lobe, approximately 8 mm x 7 mm in size. Emphysema with pulmonary bullae was also observed in both lungs. Preoperative abdominal plain CT scan. (B) Nodular dense shadow in the liver, nodular dense shadow in the duodenal region, and several nodules in both kidneys, with the largest one having a long diameter of about 64 mm. Preoperative three-dimensional imaging of the thoracic aorta. (C) Fenestration patent ductus arteriosus with pulmonary hypertension. (D) Before the operation, anecho interruption was observed between the origin of the left pulmonary artery and the descending aorta, approximately 13 mm in width (window type), with a continuous left-to-right shunt detected at the level of the large artery. Vmax was approximately 3.2 m/s, and Vmin was approximately 1.7 m/s. (E) During the operation, the occluder-like echo was detected between the origin of the left pulmonary artery and the descending aorta. The position was fixed, the traction test was negative, and no significant blood flow acceleration was detected at the origin of the descending aorta and the origin of the left pulmonary artery. (F) After the operation, the thickness of the interventricular septum and left ventricular posterior wall was normal. The overall motion amplitude of the left ventricular wall was slightly decreased, the diameter of the ascending aorta was widened, and the occluder-like hyperecho was detected between the origin of the left pulmonary artery and the descending aorta. (G) Pathological examination of the skin on the left waist showed hyperkeratosis of the epidermis and a few lymphocytes infiltration around the small vessels of the dermis. (H) Pathological examination of the skin on the left foot also showed hyperkeratosis of the epidermis and a few lymphocytes infiltration around the small vessels of the dermis.
case_images: fcvm-11-1391775-g002.jpg
case_images: PMC11306133_01_fcvm-11-1391775-g002.jpg
case_images: F2
case_images: Pathological examination of the skin on the left waist and left foot showed hyperkeratosis of the epidermis and a few lymphocytes infiltration around the small vessels of the dermis (Figure 2).