**1. Introduction**

The tuberous sclerosis complex (TSC) is an extremely variable disease that can affect any organs, from the brain, eyes, kidneys, skin, heart, and lungs, to occasionally the bones, because of growing benign tumors [1]. Until the 1980s, TSC was underdiagnosed when individuals with less severe manifestations of the disease began to be recognized. Nowadays, it has been established that the genetic component of this disease is linked to TSC1 and TSC2 genes' alterations [2]. Pathogenic mutations in either the TSC2 gene at chromosome 16p13.3, or the TSC1 gene at chromosome 9q34, cause a multisystem disorder that greatly varies in extent and severity [3]. TSC has an autosomal

dominant mode of inheritance, with almost complete penetrance, but variable expressivity [1]. Both genders and all ethnic groups could be affected by TSC [1]. More so, since 2010 the m-TOR inhibitor drugs are administrated as a medical treatment for the benign tumors, in combination with a possible surgical management [2].
