CASE REPORT
A 29-year-old male presented with a one-month history of left cheek pain
and a two-week history of left cheek swelling. He had a history of
diabetes and was receiving hypoglycemic medication. His mother died of
gastric cancer, and his aunt had a history of total colectomy. An
endoscopic examination revealed an elevated anterior nasal floor and
closed inferior meatus bilaterally (Fig. 1). Mucopurulent discharge was
noted in the left middle meatus.
Intraoral examination revealed multiple caries and tooth defects (Fig.
2). Computed tomography showed nodular osteosclerosis of the maxilla and
mandible (Fig. 3a, b) and multiple impacted maxillary teeth. Soft tissue
shadows and bone erosion were observed around the upper left impacted
tooth. Additionally, the soft tissue shadow around the impacted tooth
was continuous with the left maxillary sinus (Fig. 3c, d). Multiple
osteomas were found in the ethmoid sinus, frontal sinus, and skull (Fig.
4). We diagnosed the patient with left odontogenic maxillary sinusitis.
GS was suspected due to the positive family history, multiple osteomas
of the skull and facial bone, and abnormal teeth. Multiple adenomas were
found in the stomach and colon (Fig. 5) on gastrointestinal endoscopy.
Furthermore, genetic testing revealed a mutation in the adenomatous
polyposis coli (APC ) gene, leading to a diagnosis of GS.
Sinusitis improved following tooth extraction and macrolide therapy for
three months. Prophylactic colectomy has been planned for FAP.