Most people think of cancer as something that appears suddenly, often later in life, with warning signs that are hard to miss. But some conditions don’t follow that script at all. They begin quietly, sometimes in the teenage years, long before anyone thinks to look deeper.Gardner’s syndrome is one of those conditions. It was first identified by a geneticist, Eldon J. Gardner in 1951.It’s rare, and that’s part of the problem. Because when something is uncommon, it’s easy to overlook. A few unusual symptoms here and there—maybe a lump, maybe some dental changes, maybe stomach discomfort—and none of it immediately points to something serious. But underneath, the body may already be setting the stage for something far more dangerous.A report published in the Clinical Case Reports journal in 2024 had highlighted the case of Gardner syndrome in an African adult male who didn’t walk in complaining about something clearly linked to the intestines. Instead, he had signs outside the gut—things like jaw issues, swelling, or other unusual growths. And that’s where it gets critical. Because Gardner’s syndrome doesn’t always start with stomach problems. It can show up in the bones, skin, or teeth long before anything serious happens inside the colon.
Once they looked closer and connected the dots, they ran further tests, including colon checks. That’s when they found what really mattered, multiple polyps in the colon, which are basically small growths that can turn into cancer over time if ignored.“Gardner syndrome is an uncommon genetic disorder and an offshoot of Familial Adenomatous Polyposis. It produces a large number, hundreds to thousands of adenomatous polyps in the colon and rectum and has additional extra-intestinal findings that include bony growths, osteomas which develop in the skull or jaw, epidermoid cysts, desmoid tumors, and abnormal teeth.
This syndrome results from a mutation of the APC gene located on chromosome 5q and has an inheritance pattern of autosomal dominant inheritance.
If adenomatous polyps are not treated, they will usually develop into colorectal cancer, this usually happens between ages 35 and 40. Therefore, early detection and treatment are imperative,” says Dr. Pearl Anand, Consultant -Radiation Oncology, Andromeda Cancer Hospital Sonipat.“Those who are genetically predisposed to Gardner’s syndrome inherit a mutation within their APC gene, especially if they have a parent or sibling with the syndrome since they have a 50% chance of developing the syndrome, therefore, those who have relatives affected have the greatest potential of developing Gardner’s syndrome and are at the highest risk. Gardner’s syndrome usually develops in the adolescent years with the majority of the symptoms (polyps) occurring in the teenage years.
By the time an individual reaches early adult age without treatment to prevent or delay occurrence, they will have almost a 100% chance of developing colorectal cancer. Some of the clinical findings that suggest potential increase in the risk of developing Gardner’s syndrome include polyps in the colon at an early age, bone growths in the skul or jaw, recurrent abdominal masses due to desmoid tumors, and skin lesions that look like epidermoid cysts.
Early identification of Gardner’s syndrome may be through genetics and assessing family history of the syndrome,” the doctor explains. “Gardner’s syndrome needs a combination of close follow-up and prompt surgical treatment. Prophylactic colectomy, surgery to remove the colon, is the primary treatment for Gardner’s syndrome because it is performed to reduce the risk of colon cancer. If surgery is postponed, routine colonoscopy, every 1 to 2 years is necessary.
Desmoid tumors may be conservatively managed or treated with medications (NSAIDs, anti-estrogens or chemotherapy) if they are aggressive.
The treatment for other manifestations, such as cysts or teeth problems, is symptomatic. Chemopreventive agents,i.e, sulindac or celecoxib, may help decrease the number of polyps, but will not substitute for surgery. To provide comprehensive care, it is important to conduct surveillance throughout life, including routine examinations of the gastrointestinal tract and thyroid,” the doctor adds. Medical experts consulted This article includes expert inputs shared with TOI Health by:Dr. Pearl Anand, Consultant -Radiation Oncology, Andromeda Cancer Hospital SonipatInputs were used to explain a rare disorder called Gardner Syndrome.
