1
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Hines ES, Giaretta PR, Cavasin JP, Church ME, Sadanaga KK, Porter BF. Brunner's gland adenomas in two cats. JFMS Open Rep 2024; 10:20551169241241208. [PMID: 39070185 PMCID: PMC11283668 DOI: 10.1177/20551169241241208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024] Open
Abstract
Case series summary Two cats, aged 13.5 and 14 years, presented with duodenal masses ultimately diagnosed as Brunner's gland (BG) adenomas. In the first cat, the lesion was a firm, pale tan, proximal duodenal polyp adjacent to the major duodenal papilla that was composed histologically of a well demarcated, expansile mass of well-differentiated BGs separated by fibrovascular septa and few adipocytes. This patient was euthanized for otitis-related vestibular signs, and the clinical significance of the duodenal polyp is unknown. The second cat presented with a 6-month history of vomiting. This cat had a mural duodenal mass in the region of the major duodenal papilla of approximately 2 cm, which was histologically composed of a dense population of variably ectatic BGs expanding the submucosa and lamina propria. This patient's mass was non-resectable, but the vomiting resolved after palliative gastroenterostomy loop surgery to allow ingesta to flow past the mass. The patient survived 35 months after the procedure. Relevance and novel information BG adenoma is a rare, typically benign tumor in humans with non-specific clinical manifestations and no clear etiopathogenesis. This lesion, and the related condition BG hyperplasia, has been documented rarely in animals (one dog, two horses, and in mice and rats). This is the first description of the lesion in the cat. The comparative pathology, differential diagnoses and possible significance of these lesions are discussed.
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Affiliation(s)
- Elizabeth S Hines
- Department of Veterinary Pathobiology, Texas A&M University, School of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Paula Roberta Giaretta
- Department of Small Animal Clinical Sciences, Texas A&M University, School of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - João Pedro Cavasin
- Department of Small Animal Clinical Sciences, Texas A&M University, School of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
| | - Molly E Church
- Department of Pathobiology, University of Pennsylvania, Ryan Veterinary Hospital, Philadelphia, PA, USA
| | | | - Brian F Porter
- Department of Veterinary Pathobiology, Texas A&M University, School of Veterinary Medicine & Biomedical Sciences, College Station, TX, USA
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2
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Shmais M, Mousawi A, Mourad F, Sharara AI. Brunner's gland hamartomas: Not always benign. Arab J Gastroenterol 2024; 25:70-73. [PMID: 38296695 DOI: 10.1016/j.ajg.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 12/14/2023] [Accepted: 12/23/2023] [Indexed: 02/02/2024]
Abstract
Brunner's gland hamartoma (BGH) is a rare, benign tumor of the duodenum. It is mostly asymptomatic and usually found incidentally on routine esophagogastroduodenoscopy (EGD). However, some BGHs present with major complications including anemia, bleeding, obstruction, or dysplasia, requiring management and resection of these lesions. Herein, we present two cases of large BGHs of the duodenum, one presenting as severe gastrointestinal bleeding and the other, noted on EGD for iron deficiency anemia, found to have high grade dysplasia. This literature review discusses the rare serious complications of BGH, including iron deficiency anemia, overt gastrointestinal bleeding, and malignant potential.
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Affiliation(s)
- Manar Shmais
- Division of Gastroenterology and Hepatology, Saint Louis University Hospital, MO, USA.
| | - Ahmad Mousawi
- Division of Gastroenterology and Hepatology, American University of Beirut, Beirut, Lebanon.
| | - Fadi Mourad
- Division of Gastroenterology and Hepatology, American University of Beirut, Beirut, Lebanon.
| | - Ala I Sharara
- Division of Gastroenterology and Hepatology, American University of Beirut, Beirut, Lebanon.
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3
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Duan J, Wang X, Xu C, Guo R. The Brunner adenoma of the duodenum with positive fecal occult blood and anemia: A case report. Medicine (Baltimore) 2024; 103:e36737. [PMID: 38181268 PMCID: PMC10766290 DOI: 10.1097/md.0000000000036737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/30/2023] [Indexed: 01/07/2024] Open
Abstract
RATIONALE Brunner gland adenoma (BGA) is a rare benign duodenal tumor that is an adenomatoid lesion in nature rather than an actual tumor. Patients with different adenoma sizes have various clinical manifestations with nonspecific clinical symptoms. Here, We report a case of BGA with black stool and anemia as the primary manifestations. PATIENT CONCERNS A young female patient was admitted to the hospital because of black stool and anemia. Endoscopic surgery was performed to a definitive diagnosis, and endoscopic tumor-like lesions were resected. DIAGNOSIS The patient was diagnosed with duodenal Brunner adenoma and received related treatment. OUTCOMES After treatment, the patient symptoms improved, and he was discharged. LESSONS Brunner adenoma of the duodenum is a rare benign duodenum tumor. This report paper describes a case of BGA with black stool and anemia as the primary manifestations, followed by endoscopic resection and treatment. The literature on Brunner adenoma of the duodenum has been analyzed and discussed. Clinicians should pay attention to differentiating the disease based on atypical symptoms.
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Affiliation(s)
- Junwei Duan
- Changchun University of Chinese Medicine Changchun, Changchun, Jilin, China
| | - Xiaoyan Wang
- The First Clinical Hospital of Jilin Academy of Chinese Medicine, Changchun, Jilin, China
| | - Chenxi Xu
- The First Clinical Hospital of Jilin Academy of Chinese Medicine, Changchun, Jilin, China
| | - Rongxin Guo
- Changchun University of Chinese Medicine Changchun, Changchun, Jilin, China
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4
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Marano A, Sacco M, Rorato LM, Caronna S, Di Giovanni F, Santarelli M, De Angelis CG. Combined laparoscopic-endoscopic resection of a bleeding giant duodenal Brunner's gland hamartoma. Endoscopy 2023; 55:E983-E984. [PMID: 37604440 PMCID: PMC10442194 DOI: 10.1055/a-2134-9639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Affiliation(s)
- Alessandra Marano
- General and Specialist Surgery Department, Emergency General Surgery Unit, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Marco Sacco
- Gastroenterology Department, Endoscopy Unit, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Lisa Marie Rorato
- General and Specialist Surgery Department, Emergency General Surgery Unit, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Stefania Caronna
- Gastroenterology Department, Endoscopy Unit, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Fabrizia Di Giovanni
- Pathology Unit, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Mauro Santarelli
- General and Specialist Surgery Department, Emergency General Surgery Unit, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Claudio Giovanni De Angelis
- Gastroenterology Department, Endoscopy Unit, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
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5
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Chong A, Lewin J, Goh IY, Liu C. Brunner's gland adenoma: a robotic approach. BMJ Case Rep 2023; 16:e254566. [PMID: 37907319 PMCID: PMC10619083 DOI: 10.1136/bcr-2023-254566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023] Open
Abstract
This report describes an unusual case of a symptomatic Brunner's gland adenoma arising in a man in his 40s that underwent robotic transduodenal resection. Initial investigations revealed a polypoidal, submucosal lesion that was found in the first part of the duodenum. Microscopically, there was neither dysplasia nor evidence of adenocarcinoma, suggesting differentials of gastrointestinal stroma tumour and duodenal adenoma. Given the size of the lesion, he underwent a surgical resection. Symptomatic Brunner's gland adenoma is uncommon and should be considered as a differential diagnosis in patients presenting with obstructive symptoms.
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Affiliation(s)
- Alyssa Chong
- General Surgery, Mater Hospital Brisbane, Brisbane, Queensland, Australia
| | - Joel Lewin
- General Surgery, Mater Hospital Brisbane, Brisbane, Queensland, Australia
| | - Ian Y Goh
- General Surgery, Mater Hospital Brisbane, Brisbane, Queensland, Australia
| | - Cheng Liu
- Anatomical Pathology, Mater Hospital Brisbane, Brisbane, Queensland, Australia
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6
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Xiang Y, Liu J, Wang NY, Tang D, Wang L, Zou PX, Xu G, Huang Q. The Characteristics and Treatment Outcomes of 71 Duodenal Brunner's Gland Adenomas with Endoscopic Submucosal Dissection. Dig Dis 2023; 41:852-859. [PMID: 37591214 DOI: 10.1159/000531231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 05/09/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION The aim of this study was to investigate outcomes of patients with duodenal Brunner's gland adenomas (BGAs) that were treated endoscopically. METHODS We identified 71 consecutive patients treated at our center with endoscopic submucosal dissection (ESD) for their duodenal tumors diagnosed pathologically as BGAs over the period between January 1, 2011 and December 31, 2021. We retrospectively analyzed our experience and short- and long-term outcomes of ESD therapy on patients with BGAs. RESULTS Among 71 BGA patients with an average age of 57 ± 11.7 years (range: 30-82), 48 (67.6%) were male and 23 (32.4%) were female. The accuracy of preoperative diagnosis with endoscopic ultrasonography was 44.0% (22/50). The H. pylori infection was found in 29 patients (29/71, 40.8%). The median size of BGAs was 1.5 cm (interquartile range [IQR] 0.8-2.7 cm). The most common location was the duodenum bulb (50/71, 64.8%). For the ESD procedure, the median operation time was 15.0 min (IQR 9.5-25.5 min). The en bloc and the complete resection rates were 97.2% and 92.3%, respectively. ESD-related mild acute obstructive pancreatitis was present in 2 patients (2/4, 50%) with BGAs located in the ampulla region. During the follow-up period, 1 patient with a positive peripheral margin experienced tumor recurrence 2 years after the initial ESD. There was no disease-related death for the cohort. CONCLUSION ESD was an effective and safe therapeutic option for BGA patients with excellent outcomes. Long-term follow-up is needed.
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Affiliation(s)
- Ying Xiang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China,
| | - Jinyan Liu
- Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Nan Ya Wang
- Department of Gastroenterology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Dehua Tang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Lei Wang
- Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Ping Xiao Zou
- Department of Gastroenterology, Taikang Xianlin Drum Tower Hospital, Nanjing, China
| | - Guifang Xu
- Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Qin Huang
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
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7
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Hong P, Ghanim M, Haseeb A, Ding X, Abegunde AT. Recurrence of Brunner Gland Adenocarcinoma After Duodenectomy and Gastrojejunostomy. ACG Case Rep J 2023; 10:e01060. [PMID: 37305801 PMCID: PMC10249712 DOI: 10.14309/crj.0000000000001060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/24/2023] [Indexed: 06/13/2023] Open
Abstract
Malignant neoplasms arising from the Brunner gland are exceedingly rare. A 62-year-old man with a history of surgical resection of Brunner gland adenocarcinoma presented with upper extremity cellulitis. Hospital course was complicated by atrial fibrillation and hematochezia. Bidirectional endoscopy was negative; however, small bowel enteroscopy revealed recurrence of Brunner gland adenocarcinoma 6 years after surgical resection. To our knowledge, this is the first reported case of recurrent Brunner gland adenocarcinoma after curative resection.
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Affiliation(s)
- Paul Hong
- Department of Internal Medicine, Loyola University Medical Center, Maywood, IL
| | - Marcel Ghanim
- Division of Gastroenterology and Nutrition, Loyola University Medical Center, Maywood, IL
| | - Abdul Haseeb
- Division of Gastroenterology and Nutrition, Loyola University Medical Center, Maywood, IL
| | - Xianzhong Ding
- Department of Pathology, Loyola University Medical Center, Maywood, IL
| | - Ayokunle T. Abegunde
- Division of Gastroenterology and Nutrition, Loyola University Medical Center, Maywood, IL
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8
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Al Hariri B, Haider V, Nashwan AJ, Mohamedali M. Brunneroma: A Case of Uncommon Gastrointestinal Bleeding in a Young Adult. Cureus 2023; 15:e35127. [PMID: 36945276 PMCID: PMC10025575 DOI: 10.7759/cureus.35127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2023] [Indexed: 02/20/2023] Open
Abstract
Brunner's gland hyperplasia (BGH) or Brunneroma is an uncommon benign proliferative lesion of the small intestine. It is primarily found in the duodenal submucosa, and its main function is to create an alkaline-based mucus to protect the duodenum from stomach acid. BGH can manifest as hyperplasia or a polypoidal tumor and is often discovered incidentally during endoscopy or imaging. Less than 200 cases have been reported in the literature, and it rarely causes gastrointestinal bleeding. In this case report, we present a case of a 25-year-old male who presented with bloody stools and fainting due to severe anemia and underlying gastrointestinal pathology.
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9
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Ortega M, Sparks J, Lichy J, Nava VE. KRAS G12D mutation in Brunner gland adenoma. BMJ Case Rep 2023; 16:e252160. [PMID: 36707100 PMCID: PMC9884920 DOI: 10.1136/bcr-2022-252160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Brunner gland lesions (BGLs) encompass benign proliferations of the homonymous glands and have been designated as hyperplasia, adenoma (BGA), hamartoma or nodule. In general terms, lesions larger than 0.5 cm are considered true neoplasia with unknown malignant potential and unclear pathogenesis. Genetic alterations have seldom been reported in BGL, and include SMAD4/DPC4 and LRIG1, but not KRAS (Kirsten rat sarcoma viral oncogene homologue) to the best of our knowledge.We present the case of a man in his 60s, evaluated for iron deficiency anaemia harbouring a 1.5 cm BGA found by duodenoscopy. Immunohistochemistry failed to reveal microsatellite instability, and next-generation sequencing revealed a KRAS G12D point mutation.
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Affiliation(s)
- Mahatma Ortega
- Pathology, George Washington University School of Public Health and Health Services, Washington, District of Columbia, USA
| | - Jessica Sparks
- University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Jack Lichy
- Department of Pathology, George Washington University, Washington, District of Columbia, USA
| | - Victor E Nava
- Department of Pathology, George Washington University, Washington, District of Columbia, USA
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10
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Pantaleón Sánchez M, Pioche M, Figueiredo Ferreira M, Milashka Brihay M, Rivory J, Yzet C. Giant Brunner's gland hamartoma of the duodenal bulb removed by endoscopic submucosal dissection. Endoscopy 2022; 54:E1018-E1019. [PMID: 36002011 PMCID: PMC9736750 DOI: 10.1055/a-1893-5782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | - Mathieu Pioche
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Lyon, France
| | | | | | - Jérôme Rivory
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Lyon, France
| | - Clara Yzet
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Lyon, France
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11
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Dhali A, Ray S, Mandal TS, Das S, Ghosh R, Khamrui S, Dhali GK, Sarkar A. Surgical Outcome of Brunner's Gland Hamartoma: A Single-Centre Experience. Surg J (N Y) 2022; 8:e14-e18. [PMID: 35059497 PMCID: PMC8763466 DOI: 10.1055/s-0041-1741510] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 12/02/2021] [Indexed: 01/04/2023] Open
Abstract
Introduction
Brunner's gland hamartomas (BGH) are rare benign lesions with an incidence of <0.01%, accounting for 5 to 10% of all benign tumors of the duodenum. It requires expeditious management by a multidisciplinary team. The aim of the study is to report our experience with surgery for BGH.
Methodology
Data of all patients who underwent surgical intervention for duodenal polypoidal mass between August 2007 and March 2020 were retrieved from our prospectively maintained gastrointestinal (GI) surgery database. All patients whose histopathology report of the resected specimen confirmed BGH (
n
= 9) were included in the present study. Other pathological diagnosis like duodenal lipoma (
n
= 2), ganglioneuroma (
n
= 1), adenoma (
n
= 10), and adenocarcinoma (
n
= 4) were excluded.
Results
Nine patients had confirmatory histopathological diagnosis of BGH and met our inclusion criteria. Three (33.3%) of them were men with a median age of 45 (range: 24–61) years. The median interval between onset of symptoms and diagnosis of duodenal polyp was 14 (range: 4–180) days. Five patients (55.5%) presented with upper GI hemorrhage. Three (33.3%) patients presented with abdominal pain, and one (11.1%) patient presented with episodes of bilious vomiting. Diagnostic endoscopy could detect the lesion in all (100%) patients. Contrast-enhanced computed tomography detected duodenal polypoidal lesion in five (55.5%) patients. The mean size of tumor was 4.78 ± 1.36 cm. These lesions were symptomatic in all the patients and warranted intervention. In view of failed endoscopic intervention (
n
= 7, 77.7%), or extramural extension of the tumor (
n
= 2, 22.2%), surgical intervention was considered. Most commonly performed operation was duodenal polypectomy (
n
= 6, 66.6%). Three postoperative complications developed in two (22.2%) patients. There was no surgery-related mortality. After a median follow-up of 60 (12 -78) months, no patient developed GI bleed or intestinal obstruction.
Conclusion
In this study, the clinical profile of BGH was explored from the surgeon's point of view. Although endoscopic management is the first-line treatment, surgery plays an important role, particularly, if this fails or is not feasible. In experienced hand, surgery can be performed with acceptable perioperative morbidity and mortality and long-term satisfactory outcomes.
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Affiliation(s)
- Arkadeep Dhali
- Department of Gastrointestinal Surgery, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Sukanta Ray
- Department of Gastrointestinal Surgery, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Tuhin S. Mandal
- Department of Gastrointestinal Surgery, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Somak Das
- Department of Gastrointestinal Surgery, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Ranajoy Ghosh
- Department of Gastrointestinal Pathology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Sujan Khamrui
- Department of Gastrointestinal Surgery, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Gopal K. Dhali
- Department of Gastroenterology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - Avik Sarkar
- Department of Gastrointestinal Radiology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
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12
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Nguyen LC, Vu KT, Vo TTT, Trinh CH, Do TD, Pham NTV, Pham TV, Nguyen TT, Nguyen HC, Byeon JS. Brunner’s gland hyperplasia associated with lipomatous pseudohypertrophy of the pancreas presenting with gastrointestinal bleeding: A case report. World J Clin Cases 2021; 9:9670-9679. [PMID: 34877305 PMCID: PMC8610885 DOI: 10.12998/wjcc.v9.i31.9670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/26/2021] [Accepted: 09/19/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Brunner’s gland hyperplasia (BGH) is a rare benign lesion of the duodenum. Lipomatous pseudohypertrophy (LiPH) of the pancreas is an extremely rare disease. Because each condition is rare, the probability of purely coincidental coexistence of both conditions is extremely low.
CASE SUMMARY We report a 26-year-old man presenting to our hospital with symptoms of recurrent upper gastrointestinal bleeding. Upper gastrointestinal endoscopy showed a huge pedunculated polypoid lesion in the duodenum with bleeding at the base of the lesion. Histopathological examination of the duodenal biopsy specimens showed BGH. Besides, abdominal computed tomography and magnetic resonance imaging revealed marked fat replacement over the entire pancreas, confirmed by histopathological evaluation on percutaneous pancreatic biopsies. Based on the radiological and histological findings, LiPH of the pancreas and BGH were diagnosed. The patient refused any surgical intervention. Therefore, he was managed with supportive treatment. The patient’s symptoms improved and there was no further bleeding.
CONCLUSION This is the first well-documented case showing the coexistence of LiPH of the pancreas and BGH.
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Affiliation(s)
- Long Cong Nguyen
- Gastroenterology and Hepatology Center, Bach Mai Hospital, Hanoi 10000, Viet Nam
- Department of Gastroenterology, School of Medicine and Pharmacy, Vietnam National University Hanoi, Hanoi 10000, Viet Nam
| | - Khanh Truong Vu
- Gastroenterology and Hepatology Center, Bach Mai Hospital, Hanoi 10000, Viet Nam
- Department of Gastroenterology, School of Medicine and Pharmacy, Vietnam National University Hanoi, Hanoi 10000, Viet Nam
| | - Trang Thi Thuy Vo
- Gastroenterology and Hepatology Center, Bach Mai Hospital, Hanoi 10000, Viet Nam
| | - Chau Ha Trinh
- Radiology Center, Bach Mai Hospital, Hanoi 10000, Viet Nam
| | - Tan Dang Do
- Radiology Center, Bach Mai Hospital, Hanoi 10000, Viet Nam
| | - Ngoc Thi Van Pham
- Gastroenterology and Hepatology Center, Bach Mai Hospital, Hanoi 10000, Viet Nam
| | - Tuyen Van Pham
- Pathology Center, Bach Mai Hospital, Hanoi 10000, Viet Nam
| | | | - Hiep Canh Nguyen
- Pathology Center, Bach Mai Hospital, Hanoi 10000, Viet Nam
- Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa 920-8640, Japan
| | - Jeong-Sik Byeon
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
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13
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Olcina Domínguez P, Estela Villa L, Villadóniga Sánchez A, Avellana Moreno R, Gil Rojas S, García-Cano Lizcano J. Brunneroma: an infrequent duodenal neoplasm. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 114:124. [PMID: 34607439 DOI: 10.17235/reed.2021.8349/2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Brunneroma or Brunner gland's adenoma is an uncommon type of gastrointestinal tumor, frequently asymptomatic and rarely has malignant transformation. After an initial finding at upper endoscopy, endoscopic ultrasound and computer tomography are helpflul in planning treatment. Resection offers a definitive diagnosis.
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Affiliation(s)
| | - Luis Estela Villa
- Cirugía General y Aparato Digestivo, Hospital Virgen de la Luz, España
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