Gardner syndrome

Case contributed by Henry Knipe
Diagnosis almost certain


Jaw pain.

Patient Data

Age: 30 years
Gender: Male

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. 


Multiple mandibular and to lesser extent maxillary osteomas. The largest osteomas involves the right hemi-mandible.

The patient is and edentulous. There is unerupted presumed supernumerary teeth in the region of the left maxillary canine and the left mandibular canine. Within the teeth bearing areas of the maxilla and the mandible, there are multiple areas of other calcification - ossification; probably represent complex odontomas.

There is a presumed complex odontoma in right anterior maxilla with identifiable crown anteriorly; the latter is surrounded by a halo of lucency.

There is hypoplasia of the frontal sinuses. The inferior alveolar nerve canals are small and laterally displaced and encroached by the multiple osseous lesion.

Case Discussion

The patient had proven familial adenomatous polyposis on gene testing and had abdominal MRI (not shown) showing duodenal polyps. This history along with the findings of numerous facial osteomas is diagnostic of Gardener syndrome. 

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