Early Initial Diagnosis of Gardner Syndrome in a 12-Year-Old Boy

A 12-year-old boy presented to his primary care physician with a painful lump at the angle of the left mandible after being kicked in the jaw during a soccer game. Over the next 2 months the lesion became progressively firmer and fine needle aspiration was attempted. Results were non-diagnostic. Panorex examination revealed a calcified mass contiguous with the left angle of the mandible. Considerations were bony callus secondary to trauma versus a calcified hematoma. A maxillofacial CT showed multiple diffuse craniofacial osseous lesions including the clinically suspected region at the left angle of the mandible. Imaging findings were consistent with multiple craniofacial osteomas and workup for Gardner Syndrome was initiated. Genetic testing was subsequently positive for Familial Adenomatous Polyposis.