Surgical Management of Giant, Disfiguring Facial Angiofibromas in Tuberous Sclerosis

Background: Tuberous sclerosis complex (TSC) is a rare genetic disorder that affects many systems in the body. It is marked by benign hamartomas in many organs, especially the skin, brain, and kidneys. Facial angiofibromas are one of the most obvious skin problems that can lead to severe cosmetic damage and mental distress if not treated. Case Presentation: We are writing about a 41-year-old man who had a history of TSC, epilepsy, intellectual disability, and mental illness. He came in with multiple facial lesions that were getting bigger and causing severe disfigurement and partial airway obstruction. A physical exam showed many dark brown, round, soft tumours on the nose, cheeks, eyelids, ears, and forehead. The nostrils were completely blocked. The lesions were surgically removed from the patient, and then a split-thickness skin graft was done. Histopathology showed that there were more than one angiofibromas. Conclusion: This case shows how hard it is to treat large facial angiofibromas in TSC, especially in people who have neuropsychiatric problems and can't talk well. Surgical excision remains a viable option in advanced cases where conservative therapy is insufficient, offering both functional and cosmetic improvement.