Presentation
Right sided jaw swelling.
Patient Data
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
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.
Select images show several small polyps in the duodenum and stomach.
Case Discussion
The combination of GI polyps and osteomas (typically in the mandible) are features of Gardner syndrome.