Here is another example of polyposis with numerous small polyps covering the colonic mucosa. In this particular case, there were additional manifestations including osteomas of the skull, a periampullary adenocarcinoma, and epidermal inclusion cysts. Thus, this is a variation of familial adenomatous polyposis syndrome. The apparent inheritance pattern is autosomal dominant, with mutation of the adenomatous polyposis coli (APC) gene.