tuberous sclerosis ( tsc ) is a multi system genetic disorder affecting skin , brain / nervous system , kidneys , heart and lung and leading to growth of non malignant tumors . a combination of symptoms may include seizures , developmental delay , behavioral problems , skin abnormalities , lung and kidney disease . tuberous sclerosis lesions infrequently cause symptoms in the endocrine , gastrointestinal ( gi ) , and lymphatic systems . a 26-year - old female presented with galactorrhea for the past 10 days and menstrual irregularities over the past six months . she denied any history of substance abuse , drug intake ( antipsychotic , anti emetic , hormonal preparations ) , hypothyroidism , chronic liver or kidney diseases , epilepsy . she was a well nourished female with mild pallor , tiny nodule on face , subungual fibroma in hands . serum prolactin was 85 ng / ml with fsh-4.66 and lh- 4.21 miu / ml . in view of the theoretical possibility of involvement of cell groups of other anterior pituitary lineage , tests for evaluation of other anterior pituitary hormones were carried out and were found to be normal . abdominal and pelvic ultrasound revealed no abnormality . computed tomography ( ct ) scan revealed multiple intracerebral calcifications . these calcified lesions / subependymal hamartomas are seen along the lateral surface of the lateral ventricles giving rise to characteristic candle dripping appearance . magnetic resonance imaging ( mri ) of the brain ruled out the presence of any pituitary mass . the combined clinical scenario along with the radiologic findings leads to the diagnosis of tsc with hyperprolactinemia . patient was prescribed cabergoline 0.5 mg twice daily , which resulted in amelioration of galactorrhea and regularization of menses . there is a growing body of evidence that tsc patients develop hormone secreting tumors involving the neuroendocrine system at higher frequency than the general population . cushing 's disease , hypoglycemia secondary to insulinomas , precocious puberty , thyrotoxicosis , hypercalcemia secondary to parathyroid adenomas , hyperprolactinemia and acromegaly have all been reported in tsc patients . the circulating prolactin of our patient may be of pituitary origin or may possibly be secreted ectopically by a hamartoma . there has been evidence linking neuroendocrine tumors to the akt / mtor / s6 kinase pathway that is regulated by the hamartin / tuberin ( tsc1/tsc2 ) complex . thus , it is beginning to appear that the occurrence of these neuroendocrine tumors ( net ) in tsc is more than random coincidence .