Findings:
There are innumerable subcortical tubers. There are also subcortical cysts in the left posterior temporal operculum. The tubers and cysts do not enhance. There are enhancing subependymal nodules. There is no evidence of subependymal giant cell astrocytoma.

There are multifocal regions of skin thickening and numerous exophytic dermal lesions in the cheeks and along the nasal ala, likely reflecting adenoma sebaceum. There may be a developing sebaceous cyst versus a fluid collection in the right cheek, which measures 1.9 x 1.4 cm in the greatest dimension.

There is a non-aggressive effusion in the left mastoid air cells. There is fluid in the nasopharynx, likely related to the support tubing.

Impression:
Findings consistent with tuberous sclerosis with subcortical tubers, subependymal nodules, and dermal lesions. There are subependymal nodules without evidence of subependymal giant cell astrocystoma. There is a sebaceous cyst in the right cheek.

Recommendations:
For your training purposes, recommendations are not included in this report.