CASE REPORT
Gardner syndrome with desmoid tumors – case report
 
More details
Hide details
1
Department of Gastroenterology with Endoscopy Unit, Medical University, Lublin, Poland
 
2
Independent Public Hospital Number 4, Lublin, Poland
 
 
Corresponding author
Anna Rycyk   

Department of Gastroenterology with Endoscopy Unit, Medical University, Lublin, Poland
 
 
J Pre Clin Clin Res. 2024;1(18):11-15
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Gardner syndrome (GS) is characterized as a type of familial adenomatous polyposis (FAP), an autosomal dominant inherited disease which, if left untreated, with 100% risk leads to the development of colorectal cancer.

Case Report:
The case is presented a of a 40-year-old man who was diagnosed with Gardner syndrome at the age of 12. During his hospitalization, the patient underwent gastroscopy, colonoscopy, and computed tomography (CT) scans of head, neck and abdomen. The examination revealed the presence of extra-intestinal manifestations of GS: desmoid tumours, osteomas, and dental cavities. At present, the patient is scheduled for enteroscopy.

Conclusions:
GS is a diagnosis of genetic testing, although clinicians should be aware of the fact that up to 30% of GS cases are detected as de novo mutations. The physical examination should always be performed with accuracy to avoid a too late diagnosis of FAP, including GS, which may result in death.

Rycyk-Bojarzyńska A, Knop-Chodyła K, Kasztelan-Szczerbińska B, Cichoż-Lach H. Gardner syndrome with desmoid tumors – case report. J Pre-Clin Clin Res. 2024; 18(1): 11–15. doi: 10.26444/jpccr/184176
 
REFERENCES (50)
1.
Khattab A, Monga DK. Turcot Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2024 Jan 3]. Available from: http://www.ncbi.nlm.nih.gov/bo....
 
2.
Aelvoet AS, Buttitta F, Ricciardiello L, Dekker E. Management of familial adenomatous polyposis and MUTYH-associated polyposis; new insights. Best Practice & Research Clinical Gastroenterology. 2022 Jun 1;58–59:101793.
 
3.
Dinarvand P, Davaro EP, Doan JV, Ising ME, Evans NR, Phillips NJ, et al. Familial Adenomatous Polyposis Syndrome: An Update and Review of Extraintestinal Manifestations. Archives of Pathology & Laboratory Medicine. 2019 May 29;143(11):1382–98.
 
4.
Giang H, Nguyen VT, Nguyen SD, Nguyen HP, Vo BT, Nguyen TM, et al. Detection of a heterozygous germline APC mutation in a three-generation family with familial adenomatous polyposis using targeted massive parallel sequencing in Vietnam. BMC Med Genet. 2018 Oct 19;19:188.
 
5.
Syngal S, Brand RE, Church JM, Giardiello FM, Hampel HL, Burt RW. ACG Clinical Guideline: Genetic Testing and Management of Hereditary Gastrointestinal Cancer Syndromes. Am J Gastroenterol. 2015 Feb;110(2):223–63.
 
6.
D’Agostino S, Dell’Olio F, Tempesta A, Cervinara F, D’Amati A, Dolci M, et al. Osteoma of the Jaw as First Clinical Sign of Gardner’s Syndrome: The Experience of Two Italian Centers and Review. J Clin Med. 2023 Feb 14;12(4):1496.
 
7.
Kozan R, Taşdöven İ, Seven TE, Aydemir S, Doğan Gün B, Cömert M. Gardner’s syndrome: Simultaneous diagnosis and treatment in monozygotic twins. Turk J Surg. 2022 Dec 20;38(4):413–7.
 
8.
Saito K, Sekine M, Goto F, Yamamoto H, Kaneda S, Sakai A, et al. Gardner syndrome with odontogenic sinusitis: A case report. Clin Case Rep. 2021 Jun 23;9(6):e04256.
 
9.
Seehra J, Patel S, Bryant C. Gardner’s Syndrome Revisited: A Clinical Case and Overview of the Literature. J Orthod. 2016 Mar 1;43(1):59–64.
 
10.
Charifa A, Jamil RT, Zhang X. Gardner Syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2024 Jan 2]. Available from: http://www.ncbi.nlm.nih.gov/bo....
 
11.
Aletaha M, Fateh-Moghadam H. Gardner Syndrome. J Ophthalmic Vis Res. 2012 Jul;7(3):257–60.
 
12.
Lucamba AJ, Grillo R, Jodas CRP, Teixeira RG. Multiple Gardner Syndrome Osteomas Mimicking Temporomandibular Ankylosis: Case Report. J Maxillofac Oral Surg. 2023 Feb 25;1–4.
 
13.
Fotiadis C, Tsekouras D, Antonakis P, Sfiniadakis J, Genetzakis M, Zografos G. Gardner’s syndrome: A case report and review of the literature. World J Gastroenterol. 2005 Sep 14;11(34):5408–11.
 
14.
Thomaidis V, Seretis K, Tsoucalas G, Razos K, Vasilopoulos A, Efenti GM, et al. A Case of Early FAP Diagnosis with Extraintestinal Manifestations on the Face. Acta Medica Academica. 2019 Oct 24;48(2):217–24.
 
15.
Putro YAP, Magetsari R, Taroeno-Hariadi KW, Dwianingsih EK, Pribadi AW, Sukotjo KK. Classic and rare manifestations of multiple osteoma: A case report. Int J Surg Case Rep. 2023 Sep;110:108713.
 
16.
Baumhoer D, Berthold R, Isfort I, Heinst L, Ameline B, Grünewald I, et al. Recurrent CTNNB1 mutations in craniofacial osteomas. Mod Pathol. 2022 Apr;35(4):489–94.
 
17.
Tan EWK, Barco JB, Rehman MU, Tan CC. Retromastoid osteoma—a rare case report. J Surg Case Rep. 2020 Jan 13;2020(1):rjz381.
 
18.
Ângelo DF, Nunes M, Monje F, Mota B, Salvado F. A role for total alloplastic temporomandibular joint replacement in Gardner syndrome. Int J Oral Maxillofac Surg. 2023 Nov 18;S0901-5027(23)00293-X.
 
19.
Heller GD. Conservative management of a fourth ventricular epidermoid in a patient with Gardner syndrome. Ther Adv Rare Dis. 2020 Oct 29;1:2633004020969702.
 
20.
Kiessling P, Dowling E, Huang Y, Ho ML, Balakrishnan K, Weigel BJ, et al. Identification of aggressive Gardner syndrome phenotype associated with a de novo APC variant, c.4666dup. Cold Spring Harb Mol Case Stud. 2019 Apr;5(2):a003640.
 
21.
Bedard T, Mohammed M, Serinelli S, Damron TA. Atypical Enostoses—Series of Ten Cases and Literature Review. Medicina (Kaunas). 2020 Oct 13;56(10):534.
 
22.
Lyons LA, Lewis RA, Strong LC, Zuckerbrod S, Ferrell RE. A genetic study of Gardner syndrome and congenital hypertrophy of the retinal pigment epithelium. Am J Hum Genet. 1988 Feb;42(2):290–6.
 
23.
Ren M, Li R, Liu L. Atypical Gardner’s Syndrome with Proptosis as the Primary Symptom. Ophthalmology [Internet]. 2023 Jun 28 [cited 2024 Jan 3];0(0). Available from: https://www.aaojournal.org/art....
 
24.
Blackwell MC, Thakkar B, Flores A, Zhang W. Extracolonic manifestations of Gardner syndrome: A case report. Imaging Sci Dent. 2023 Jun;53(2):169–74.
 
25.
Jain A, Taneja S. Bilateral presentation of different supernumerary teeth in nonsyndromic patients: case reports. Gen Dent. 2020;68(2):39–42.
 
26.
Ciriacks K, Knabel D, Waite MB. Syndromes associated with multiple pilomatricomas: When should clinicians be concerned? Pediatric Dermatology. 2020;37(1):9–17.
 
27.
Smith C, Hamilton D, Waterston S. Rare case of multiple and perforating pilomatrixomas in a young girl with lymphovascular malformation reveals a potential new disease association. BMJ Case Rep. 2022 May 25;15(5):e248076.
 
28.
Tayeb Tayeb C, Parc Y, Andre T, Lopez-Trabada Ataz D. Polypose adénomateuse familiale, tumeurs desmoïdes et syndrome de Gardner. Bulletin du Cancer. 2020 Mar 1;107(3):352–8.
 
29.
Yu F, Cai W, Jiang B, Xu L, Liu S, Zhao S. A novel mutation of adenomatous polyposis coli (APC) gene results in the formation of supernumerary teeth. J Cell Mol Med. 2018 Jan;22(1):152–62.
 
30.
Litchinko A, Brasset C, Tihy M, Amram ML, Ris F. Large Desmoid Tumour of the Pancreas: A Report of a Rare Case and Review of the Literature. Am J Case Rep. 2022 Nov 15;23:e937324-1-e937324-10.
 
31.
Shayesteh S, Salimian KJ, Fouladi DF, Blanco A, Chu LC, Fishman EK. Pancreatic cystic desmoid tumour following metastatic colon cancer surgery: A case report. Radiol Case Rep. 2020 Nov;15(11):2063–6.
 
32.
Bakker A, Slack JC, Caragea M, Kurek KC, Bründler MA. Adipocyte-rich CTNNB1-mutated Intramuscular Gardner Fibroma Progressing to Desmoid Fibromatosis. Pediatr Dev Pathol. 2021;24(1):62–7.
 
33.
Signoroni S, Piozzi GN, Collini P, Cocco IMF, Biasoni D, Chiaravalli S, et al. Gardner-associated fibroma of the neck: role of a multidisciplinary evaluation for familial adenomatous polyposis diagnosis. Tumouri. 2021 Dec;107(6):NP73–6.
 
34.
Ramírez Stieben LA, Pozzi D. Papillary thyroid carcinoma with desmoid fibromatosis: a case report and review of literature. Rev Fac Cien Med Univ Nac Cordoba. 2023 Sep 29;80(3):289–300.
 
35.
Rangunwala J, Sitta J, Prakash V, Vyas K, Roda M. Complex Case of Aggressive Intra-abdominal Desmoid-type Fibromatosis Status Post Cholecystectomy. Cureus. 2020 Mar 6;12(3):e7193.
 
36.
Aghighi M, Cloutier JM, Hoover WD, Roy K, Lo AA, Brown RA. Cutaneous desmoid-type fibromatosis: A rare case with molecular profiling. J Cutan Pathol. 2021 Sep;48(9):1185–8.
 
37.
Abu-Jeyyab M, Al-Asbahi H, Al-Jafari M, Al-Tarawneh BK, Nashwan AJ. Aggressive Fibromatosis of the Left Mesocolon Mimicking a Gastrointestinal Stromal Tumour: A Case Report. Case Rep Oncol. 2023;16(1):1148–55.
 
38.
Sioda NA, Wakim AA, Wong T, Patel S, Coan K, Row D. A Large Sporadic Intra-abdominal Desmoid-Type Fibromatosis in a Young Male: A Case Report. Front Surg. 2020;7:60.
 
39.
Maimone S, Lewis JT. Gardner Syndrome With Breast Desmoid Tumours. Mayo Clinic Proceedings. 2022 Oct 1;97(10):1894–6.
 
40.
Jin L, Tan Y, Su Z, Huang S, Pokhrel S, Shi H, et al. Gardner syndrome with giant abdominal desmoid tumour during pregnancy: a case report. BMC Surg. 2020 Nov 12;20:282.
 
41.
Malik MN, Shah Z, Rafae A, Mahmood T, Fazeel HM. Small Intestinal Tumours: A Rare Case of Tubulovillous Adenoma in Duodenum. Cureus. 11(5):e4671.
 
42.
Eizuka M, Toya Y, Kosaka T, Oizumi T, Morishita T, Kasugai S, et al. Attenuated Familial Adenomatous Polyposis. Intern Med. 2023 Sep 15;62(18):2651–4.
 
43.
Ali A, Ahmad A, Taj S, Qaudeer SA, Ahmed SE. Familial Adenomatous Polyposis (FAP) Presenting as Iron Deficiency Anemia in a 33-Year-Old Female: A Case Report. Cureus. 14(4):e24603.
 
44.
Björk J, Akerbrant H, Iselius L, Alm T, Hultcrantz R. Epidemiology of familial adenomatous polyposis in Sweden: changes over time and differences in phenotype between males and females. Scand J Gastroenterol. 1999 Dec;34(12):1230–5.
 
45.
Järvinen HJ. Epidemiology of familial adenomatous polyposis in Finland: impact of family screening on the colorectal cancer rate and survival. Gut. 1992 Mar;33(3):357–60.
 
46.
Bülow S. Results of national registration of familial adenomatous polyposis. Gut. 2003 May;52(5):742–6.
 
47.
Paramythiotis D, Kyriakidis F, Karlafti E, Koletsa T, Tsakona A, Papalexis P, et al. A Rare Case of Multiple Gastrointestinal Stromal Tumours Coexisting with a Rectal Adenocarcinoma in a Patient with Attenuated Familial Adenomatous Polyposis Syndrome and a Mini Review of the Literature. Medicina (Kaunas). 2022 Aug 18;58(8):1116.
 
48.
Shaukat A, Levin TR. Current and future colorectal cancer screening strategies. Nat Rev Gastroenterol Hepatol. 2022 Aug;19(8):521–31.
 
49.
Mallinson EKL, Newton KF, Bowen J, Lalloo F, Clancy T, Hill J, et al. The impact of screening and genetic registration on mortality and colorectal cancer incidence in familial adenomatous polyposis. Gut. 2010 Oct;59(10):1378–82.
 
50.
Gu X, Li X, Xu J, Yang J, Li H, Wu Q, et al. Accumulated genetic mutations leading to accelerated initiation and progression of colorectal cancer in a patient with Gardner syndrome. Medicine (Baltimore). 2021 Apr 2;100(13):e25247.
 
eISSN:1898-7516
ISSN:1898-2395
Journals System - logo
Scroll to top