A 10-month-old boy with a known diagnosis of tuberous sclerosis presen
ted with axillary and brachial masses. Cross-sectional imaging with co
mputed tomography, magnetic resonance, and ultrasound demonstrated uns
uspected aneurysms of the axillary and brachial arteries. The results
of these studies significantly changed the preoperative planning for t
his patient, who was scheduled for a biopsy of a presumed soft-tissue
tumor. To our knowledge, this is the first description of the cross-se
ctional imaging findings in the extremity peripheral vascular manifest
ation of tuberous sclerosis; it has only been previously described on
angiograghy in one case. The rare association of peripheral arterial a
neurysms with tuberous sclerosis is important to recognize not only fo
r clinical diagnosis but also for appropriate surgical treatment and g
enetic counseling.