In a pot of salted boiling water, cook the tortellini according to the directions on the package. Drain well and set aside.
Heat the oil in a skillet or non-stick pan over medium heat. Add the sausage and garlic; brown the sausage, breaking it up into smaller pieces until no longer pink (about 6 minutes).
Stir in the cream and simmer until thick and creamy. Then remove from the heat. Stir in the pesto sauce. Then toss in the tortellini, tomato, mozzarella, and parmesan. Season with salt and pepper to taste.
Melt the butter in a non-stick pan over medium heat. Once hot, place the bread slices into the pan, cook until golden brown. Season with oregano, salt and pepper.
Return the pan to medium heat and stir until the mozzarella becomes melty.
Serve with grilled bread, garnish with parmesan cheese before serving.