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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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Hu BW, Liu ZZ, Ding HF. Facts to be known for the better understanding of Brunner's gland adenoma and its management. Asian J Surg 2022; 45:1295-1296. [PMID: 35227566 DOI: 10.1016/j.asjsur.2021.12.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 12/29/2021] [Indexed: 11/02/2022] Open
Affiliation(s)
- Bo-Wen Hu
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, Henan, 450052, China.
| | - Zhen-Zhen Liu
- Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, Henan, 450052, China
| | - Huan-Fei Ding
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Zhengzhou, Henan, 450052, China
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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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Zhu M, Li H, Wu Y, An Y, Wang Y, Ye C, Zhang D, Ma R, Wang X, Shao X, Guo X, Qi X. Brunner's Gland Hamartoma of the Duodenum: A Literature Review. Adv Ther 2021; 38:2779-2794. [PMID: 33914269 PMCID: PMC8189944 DOI: 10.1007/s12325-021-01750-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 04/15/2021] [Indexed: 02/07/2023]
Abstract
Brunner's gland hamartoma is a benign tumor of the duodenum, but has malignant potential with a very low risk of progression into adenocarcinoma. It is uncommon with a frequency of less than 1.0% among the primary tumors of the small intestine. In addition, its clinical manifestations are nonspecific, etiology remains unclear, and treatment strategy needs to be further refined. This literature review mainly discusses the epidemiology, clinical features, possible etiology and pathogenesis, diagnostic methods, malignant potential, treatment, and prognosis of Brunner's gland hamartoma.
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Affiliation(s)
- Menghua Zhu
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, People's Republic of China
- Postgraduate College, Jinzhou Medical University, Jinzhou, People's Republic of China
| | - Hongyu Li
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, People's Republic of China
| | - Yanyan Wu
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, People's Republic of China
- Postgraduate College, Jinzhou Medical University, Jinzhou, People's Republic of China
| | - Yang An
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, People's Republic of China
- Postgraduate College, Shenyang Pharmaceutical University, Shenyang, People's Republic of China
| | - Yuye Wang
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, People's Republic of China
- Postgraduate College, Jinzhou Medical University, Jinzhou, People's Republic of China
| | - Chun Ye
- Department of General Surgery, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, People's Republic of China
| | - Dan Zhang
- Department of General Surgery, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, People's Republic of China
| | - Rui Ma
- Department of General Surgery, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, People's Republic of China
| | - Xuehan Wang
- Department of Pathology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, People's Republic of China
| | - Xiaodong Shao
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, People's Republic of China.
| | - Xiaozhong Guo
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, People's Republic of China.
| | - Xingshun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command (Formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, 110840, Liaoning Province, People's Republic of China.
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