Here is another example of polyposis with numerous small polyps covering the colonic mucosa. In this particular case, there were osteomas of the skull, a periampullary adenocarcinoma, and epidermal inclusion cysts. Thus, this is a case of Plenk-Gardner syndrome. As with familial adenomatous polyposis, the inheritance pattern is autosomal dominant, with a faulty adenomatous polyposis coli (APC) gene.