DISCUSSION
We encountered a case of Gardner syndrome with odontogenic sinusitis. Many patients with GS are asymptomatic, and diagnosis is based on incidental findings or family history. Patients with GS may exhibit tooth abnormalities such as excess teeth, impacted teeth (delayed tooth eruption), and odontoma, in addition to osteoma2. Odontoma is usually asymptomatic; however, reports of infected odontoma exist3. GS with odontogenic sinusitis is rare. As far as we are aware, there are no similar case reports. In our patient, two upper left maxillary teeth formed an odontoma, which got infected, leading to odontogenic sinusitis.
Osteoma occurs in 46%–93% of patients with GS, which is 4–20 times more frequent than in the general population. It most commonly occurs at the outer cortex of the skull, mandible, and frontal sinus2. While a single osteoma might be accidently identified in clinical practice settings, GS should be suspected if three or more osteomas are found2. Treatment is not indicated for osteoma, but surgery may be required for mandibular dyskinesia or cosmesis2.
If left untreated, patients with FAP will develop colorectal cancer4, which is the leading cause of death in this population5. Prophylactic colectomy is a reliable treatment; however, surgery is recommended for patients in their 20s. In GS, because of the mutation in APC , which is a tumor-suppressor gene, complications such as gastric cancer, duodenal cancer, thyroid cancer, and malignant dental tumors may occur, in addition to colon cancer. Desmoid tumors also greatly influence the prognosis4,5. Therefore, full-body examination and long-term follow-up are required.
An otolaryngologist may see a patient with GS presenting nasal and buccal symptoms such as sinusitis and a dental infection. GS should be suspected if characteristic findings—including multiple osteomas of the skull and facial bones, excess teeth, impacted teeth, and odontomas—are observed. Eliciting a family history and examining the whole body, including the colon, can contribute to early diagnosis and treatment, potentially improving the patient’s prognosis.