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Gardner syndrome

Case contributed by Jan Frank Gerstenmaier
Diagnosis certain

Presentation

Right sided jaw swelling.

Patient Data

Age: 30-35Y
Gender: Male
x-ray

There are unerupted teeth present with impacted left maxilla tooth (possibly canine) and left mandibular premolar. There are innumerable sclerotic lesions in the mandible and maxilla bilaterally, including pedunculated lesions in the right maxilla peripherally and right posterior body/ angle of mandible. Larger lesions are also seen in the left body of mandible and right mandibular ramus. Findings are suggestive of multiple osteomas. Malignant degeneration cannot be excluded and if this is a clinical concern then cross sectional imaging could be performed

mri

MR PANCREAS

Multiplanar pre and post contrast (dynamic) scans, as well as MRCP sequences of the pancreas have been performed. Imaged portions of the pancreas and liver are unremarkable, with no mass lesions identified. There is no pancreatic duct dilatation or common bile duct dilatation. No choledocholithiasis. Conventional pancreaticobiliary anatomy noted. Several small duodenal polyps including a larger periampullary polyp is consistent with known diagnosis of FAP.

Gastroduodenoscopy

Photo

Select images show several small polyps in the duodenum and stomach.

Annotated image

Summary images

Case Discussion

The combination of GI polyps and osteomas (typically in the mandible) are features of Gardner syndrome.

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