1
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González Peña C, Ayón Ahumada S. Hyperplasia of Brunner's glands as a cause of gastrointestinal bleeding in a young patient: endoscopic approach. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2024. [PMID: 38469814 DOI: 10.17235/reed.2024.10347/2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Brunner's gland hyperplasia or Brunneroma is a rare benign proliferative lesion of the small intestine. It is often incidentally discovered during endoscopy or imaging studies. The endoscopic presentation can be nodular, polypoid, or a diffuse glandular proliferation with thickening of the duodenal wall, which can be mistaken for malignant neoplasia. It rarely causes gastrointestinal bleeding. Is presented a case of a 25-year-old man who presented with melena and anemia secondary to Brunner's gland hyperplasia.
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Affiliation(s)
| | - Samuel Ayón Ahumada
- Gastroenterología y Endoscopia, Instituto Mexicano del Seguro Social, México
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2
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Brunner's Gland Adenoma-An Uncommon Cause for Intussusception and Gastric Outlet Obstruction. ACG Case Rep J 2023; 9:e00949. [PMID: 36628374 PMCID: PMC9820773 DOI: 10.14309/crj.0000000000000949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/30/2022] [Indexed: 01/07/2023] Open
Abstract
Brunner's gland adenoma is extremely uncommon small bowel tumors with an incidence of <0.01% and account for less than 1% of all gastrointestinal tumors. They are branched acinotubular glands found within the submucosal layer and located between the pyloric ring and the major duodenal papilla. Brunner's glands produce an alkaline secretion containing viscous mucin to protect the duodenum from acidic gastric chyme. Although these lesions are usually asymptomatic and are incidentally discovered on upper gastrointestinal endoscopy, they may occasionally present with symptoms of upper gastrointestinal hemorrhage, duodenal obstruction, and more rarely with biliary fistulation or intussusception. We present an atypical case of a large 9-cm Brunner's gland adenoma causing duodenojejunal intussusception in a 44-year-old Chinese man, who presented with long-standing epigastric pain, nausea, and vomiting.
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3
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Naito S, Fukuzawa M, Nakamura S, Kono S, Matsubayashi J, Itoi T. Giant Brunner's gland hamartoma diagnosed via endoscopic mucosal resection: A case report. DEN OPEN 2022; 2:e65. [PMID: 35310720 PMCID: PMC8828167 DOI: 10.1002/deo2.65] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 01/26/2023]
Abstract
We report the case of a patient with a giant Brunner's gland hamartoma that was pathologically diagnosed by endoscopic mucosal resection. A 69‐year‐old woman presented with intermittent abdominal pain, and imaging revealed a smooth saccular submucosal tumor, 40 mm in diameter, on the anterior wall of the duodenal bulb. Brunner's gland and smooth muscle tissue were observed on endoscopic ultrasound‐guided fine‐needle aspiration biopsy, which resulted in the preoperative diagnosis of a duplication cyst. However, subsequent endoscopic mucosal resection established a final histopathological diagnosis of Brunner's gland hamartoma.
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Affiliation(s)
- Sakiko Naito
- Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo Japan
| | - Masakatsu Fukuzawa
- Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo Japan
| | - Shunsuke Nakamura
- Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo Japan
| | - Shin Kono
- Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo Japan
| | - Jun Matsubayashi
- Department of Human Pathology Tokyo Medical University Tokyo Japan
| | - Takao Itoi
- Department of Gastroenterology and Hepatology Tokyo Medical University Tokyo Japan
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4
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Cotton J, Bavi P, Ghorab Z, James P, Stefano S, Schwock J, Ko HM. Pre-operative diagnosis of a Brunner's gland hamartoma by endoscopic ultrasound-guided fine needle aspiration. Cytopathology 2021; 32:674-676. [PMID: 33606303 DOI: 10.1111/cyt.12964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/25/2021] [Accepted: 02/05/2021] [Indexed: 11/29/2022]
Affiliation(s)
- James Cotton
- Division of Pathology, University Health Network, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Prashant Bavi
- Division of Pathology, University Health Network, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Zeina Ghorab
- Division of Anatomic Pathology, Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Science Centre, Toronto, ON, Canada
| | - Paul James
- Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Serra Stefano
- Division of Pathology, University Health Network, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Joerg Schwock
- Division of Pathology, University Health Network, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Hyang Mi Ko
- Division of Pathology, University Health Network, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
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5
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Liang M, Liwen Z, Jianguo S, Juan D, Ting S, Jianping C. A case report of endoscopic resection for the treatment of duodenal Brunner's gland adenoma with upper gastrointestinal bleeding. Medicine (Baltimore) 2020; 99:e23047. [PMID: 33350721 PMCID: PMC7769294 DOI: 10.1097/md.0000000000023047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 09/26/2020] [Accepted: 10/06/2020] [Indexed: 01/09/2023] Open
Abstract
RATIONALE Gastrointestinal bleeding as the first sign of Brunner's gland adenoma (BGA) is an extremely rare, and its clinical features and treatment methods have not been well described. PATIENT CONCERNS We described a 81-year-old female patient with coronary artery disease and chronic atrial fibrillation presenting with presenting with gastrointestinal bleeding requiring blood transfusion. DIAGNOSES The diagnosis of our case mainly refered to radiologic imaging and endoscopic examination. Histological result was compatible with BGA. INTERVENTIONS This mass lesion (6 × 7 cm diameter) was successfully totally removed by endoscopic submucosal dissection (ESD) for more than three hours. OUTCOMES The patient was followed up for 6 months to date without recurrence. LESSONS Endoscopic removal is considered as a safe and low-risk treatment for elderly patients with severe underlying diseases presenting with gastrointestinal bleeding.
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Affiliation(s)
- Ma Liang
- Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University
| | - Zhang Liwen
- Department of Pediatrics, the Second People's Hospital of Changzhou, Affiliate Hospital of NanJing medical University, Changzhou, Jiangsu
| | - Song Jianguo
- Department of Gastroenterology, The People's Hospital of Wuqia, Xin Jiang, China
| | - Dai Juan
- Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University
| | - Shen Ting
- Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University
| | - Chen Jianping
- Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University
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6
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Bhatti S, Alghamdi M, Omer E. Brunner's Gland Hyperplasia: A Massive Duodenal Lesion. Cureus 2020; 12:e7542. [PMID: 32377490 PMCID: PMC7198079 DOI: 10.7759/cureus.7542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/03/2020] [Indexed: 11/17/2022] Open
Abstract
A 57-year-old male with a history of gastroesophageal reflux disease and esophageal strictures presented with melena and abdominal pain. He underwent an esophagogastroduodenoscopy, which revealed a 5-cm duodenal bulb mass causing partial obstruction of the gastric outlet. Endoscopic ultrasound showed a 5-cm, hypoechoic lesion, arising from the mucosal layer, with a large blood vessel feeding the lesion. Biopsy revealed benign Brunner's gland hyperplasia. The large mass was causing symptomatic obstruction of the pylorus and iron deficiency anemia, and had risk for malignant transformation. Due to its size it was not amenable to endoscopic removal. Subsequently, he underwent exploratory laparotomy with pyloroplasty, duodenotomy and partial duodenal resection. Surgical pathology showed Brunner's gland hyperplasia and was negative for malignancy.
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Affiliation(s)
- Sundus Bhatti
- Internal Medicine, University of Louisville School of Medicine, Louisville, USA
| | - Mohammed Alghamdi
- Pathology, University of Louisville School of Medicine, Louisville, USA
| | - Endashaw Omer
- Gastroenterology, University of Louisville, Louisville, USA
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7
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Yi L, Cheng Z, Qiu H, Yang J, Wang T, Liu K. A giant Brunner's gland hamartoma being treated as a pedunculated polyp: a case report. BMC Gastroenterol 2019; 19:151. [PMID: 31443637 PMCID: PMC6708166 DOI: 10.1186/s12876-019-1074-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 08/19/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND With the development and application of endoscopic technology, most pedunculated polyps can be absolutely resected with a complete specimen by hot snare polypectomy (HSP). Brunner's gland hamartoma (BGH) is a rare benign small bowel tumor. The majority of BGH measuring about 2 cm in diameter, rarely larger than 5 cm. Most patients are asymptomatic, some may present with gastrointestinal hemorrhage or intestinal obstruction. Symptomatic larger lesions leading to bleeding or obstruction should be excised either endoscopically or surgically. Whether it is safe and effective that removing a BGH measuring about 7 cm by HSP is not known. CASE PRESENTATION Here, we reported a rare case of a proximal duodenum pedunculated mass measuring about 7 cm which was responsible for the patient's severe anemia. we treated it as a pedunculated polyp. After being pretreated the stalk with an endoloop which was placed around the base of the mass to prevent post-polypectomy bleeding (PPB), the pedunculated BGH was removed by HSP completely. The stalk of the mass was negative. We achieved a curative resection. CONCLUSION It is a safe and effective for our patient to treat the pedunculated BGH measuring about 7 cm as a pedunculated polyp and remove it by HSP. And future prospective studies in larger cohorts are needed to confirm it.
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Affiliation(s)
- Lizhi Yi
- Department of Gastroenterology, People's Hospital of Leshan, 238 Baita Street, Leshan, Sichuan, 614000, People's Republic of China.
| | - Zhengyu Cheng
- Department of Gastroenterology, People's Hospital of Leshan, 238 Baita Street, Leshan, Sichuan, 614000, People's Republic of China
| | - Huarong Qiu
- Department of Gastroenterology, People's Hospital of Leshan, 238 Baita Street, Leshan, Sichuan, 614000, People's Republic of China
| | - Jianjun Yang
- Department of pathology, People's Hospital of Leshan, Leshan, City, 614000, Sichuan province, People's Republic of China
| | - Tao Wang
- Department of radiology, People's Hospital of Leshan, Leshan, City, 614000, Sichuan province, People's Republic of China
| | - Ke Liu
- Department of Gastroenterology, People's Hospital of Leshan, 238 Baita Street, Leshan, Sichuan, 614000, People's Republic of China
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Hussain I, Tan M, Veeraraghavan MA, Wang LM, Kwek AEB. Endosonographic Appearances of a Rare Duodenal Tumour, Brunner's Gland Hamartoma. Case Rep Gastroenterol 2019; 13:310-320. [PMID: 31427914 PMCID: PMC6696781 DOI: 10.1159/000501674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 06/18/2019] [Indexed: 12/24/2022] Open
Abstract
Brunner's gland hamartoma (BGH) is a rare sub-epithelial tumour of the duodenum, which may cause haemorrhagic or obstructive gastrointestinal symptoms. Their accurate histological diagnosis often remains elusive before resection. Although endoscopic ultrasonography (EUS) is considered an excellent modality to study lesions within the gastrointestinal wall, only a few reports have described endosonographic characteristics of BGHs. A reliable pre-resection diagnosis with EUS may not only allay fear of malignancy but may as well avert a major surgery for the patients. In this report, we present a rare case of a large BGH in a young female who presented with acute gastrointestinal bleeding. Here, the endosonographic features assuaged the concern for malignancy while aiding in complete and uneventful surgical resection of the tumour via a submucosal plane.
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Affiliation(s)
- Ikram Hussain
- Department of Gastroenterology, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Malcolm Tan
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore
| | | | - Lai Mun Wang
- Pathology, Department of Laboratory Medicine, Changi General Hospital, Singapore, Singapore
| | - Andrew Eu Boon Kwek
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore, Singapore
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Satoh T, Matsubayashi H, Takizawa K, Ishiwatari H, Kakushima N, Fujie S, Yoshida M, Kawata N, Sasaki K, Terashima M, Ono H. Giant Brunner's Gland Hyperplasia of the Duodenum Diagnosed by Endoscopic Ultrasonography-guided Fine Needle Biopsy and Treated by Laparoscopic Endoscopic Cooperative Surgery. Intern Med 2019; 58:2009-2013. [PMID: 30918195 PMCID: PMC6702001 DOI: 10.2169/internalmedicine.2477-18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
A 57-year-old female was referred to our department for treatment of a duodenal submucosal tumor (SMT), which had been growing over the last five years. Computed tomography demonstrated a marginally enhanced mass, measuring 36 mm in diameter, containing internal multiple hypovascular areas. Endoscopic ultrasonography-guided fine needle biopsy was performed using a 20-gauge core trap needle, and the specimens showed benign Brunner's glands. She underwent laparoscopic endoscopic cooperative surgery and the SMT was completely removed without any adverse events. Histology of the resected tumor showed Brunner's gland hyperplasia (BGH). BGH is generally a benign lesion. However, an accurate diagnosis is required to avoid overtreatment when it mimics malignancy.
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Affiliation(s)
| | | | | | | | | | - Shinya Fujie
- Division of Endoscopy, Shizuoka Cancer Center, Japan
| | - Masao Yoshida
- Division of Endoscopy, Shizuoka Cancer Center, Japan
| | - Noboru Kawata
- Division of Endoscopy, Shizuoka Cancer Center, Japan
| | - Keiko Sasaki
- Division of Pathology, Shizuoka Cancer Center, Japan
| | | | - Hiroyuki Ono
- Division of Endoscopy, Shizuoka Cancer Center, Japan
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10
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A Giant Brunneroma Causing Gastrointestinal Bleeding and Severe Anemia Requiring Transfusion and Surgery. Case Rep Surg 2017; 2017:6940649. [PMID: 28299229 PMCID: PMC5337360 DOI: 10.1155/2017/6940649] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 01/26/2017] [Accepted: 01/29/2017] [Indexed: 12/29/2022] Open
Abstract
Brunner's gland hamartoma, also called hyperplasia, adenoma, and Brunneroma, is an extremely rare benign proliferative lesion of Brunner's glands in the duodenum. While being mostly small and asymptomatic, they can result in gastrointestinal bleeding and obstruction. We report the case of a 54-year-old man presenting with melena and severe anemia requiring blood transfusion. CT scans showed a large mass of 8 cm in diameter, presumably arising in the duodenum. Endoscopic biopsies were not conclusive. As we were unable to determine the nature of the mass preoperatively and due to the severe symptoms, its size, and the uncertain malignant potential, a classic Whipple procedure was performed. The resected specimen showed extensive proliferation of Brunner's glands without signs of malignancy.
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11
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Sorleto M, Timmer-Stranghöner A, Wuttig H, Engelhard O, Gartung C. Brunner's Gland Adenoma - A Rare Cause of Gastrointestinal Bleeding: Case Report and Systematic Review. Case Rep Gastroenterol 2017; 11:1-8. [PMID: 28203131 PMCID: PMC5301130 DOI: 10.1159/000454711] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/22/2016] [Indexed: 11/19/2022] Open
Abstract
Brunner's gland adenoma is an extremely rare benign small bowel neoplasm, often discovered incidentally during upper gastrointestinal endoscopy or radiological diagnostics. In few cases, it tends to cause gastrointestinal hemorrhage or intestinal obstruction. We report here our experience with a 47-year-old woman with a Brunner's gland adenoma of more than 6 cm in size, located in the first part of the duodenum and causing gastrointestinal bleeding. Initially, we performed a partial endoscopic resection using endoloop and snare alternatively to prevent severe bleeding. A rest endoscopic polypectomy with the submucosal dissection technique was planned. However, on request of the patient, an elective surgical duodenotomy with submucosal resection of the remaining small duodenal tumor was performed. To better define the patient's characteristics and treatment options of such lesions, we performed a systematic review of the available literature in PubMed. Recently, an endoscopic removal is being increasingly practiced and is considered as a safe treatment modality of such lesions.
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Affiliation(s)
- Michele Sorleto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Johannes-Wesling-Klinikum Minden, Minden, Germany
| | - Annette Timmer-Stranghöner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Johannes-Wesling-Klinikum Minden, Minden, Germany
| | - Helge Wuttig
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Johannes-Wesling-Klinikum Minden, Minden, Germany
| | - Oliver Engelhard
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Johannes-Wesling-Klinikum Minden, Minden, Germany
| | - Carsten Gartung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University Hospital Johannes-Wesling-Klinikum Minden, Minden, Germany
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12
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Santy L, Fierens J, Dedrye L. Laparoscopic treatment of a Brunner's gland hamartoma: a case report. Acta Chir Belg 2016; 116:197-200. [PMID: 27426650 DOI: 10.1080/00015458.2016.1139836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background Brunner's gland hyperplasia is a rare benign tumour and occurs most frequently in the upper part of the duodenum, mostly in the fifth or the sixth decade. Pathogenesis is still unknown. Symptoms are mostly absent, but larger lesions can cause gastric outlet obstruction or bleeding. Biopsies are necessary for differential diagnosis and to rule out cancerous changes. Mostly a resection is required. Methods A case report of a symptomatic Brunneroma is described with a review of the literature. Results: A 72-year-old female presented with melena due to a post-pyloric Brunneroma. After medical work-up a full laparoscopic resection was performed, with an uneventful recovery. Conclusion Brunner's gland hyperplasia is a benign lesion, although malignant transformation has been described. Small pedunculated Brunneromas can be resected endoscopically, but larger lesions need surgical treatment. A full laparoscopic treatment is possible and safe.
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13
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Huo X, Wei J, Liu X, Wu J, Gao W, Li Q, Jiang K, Dai C, Miao YI. Brunner's gland cyst in combination with gastrointestinal stromal tumor: A case report. Oncol Lett 2016; 11:3409-3412. [PMID: 27123125 DOI: 10.3892/ol.2016.4382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 02/01/2016] [Indexed: 12/12/2022] Open
Abstract
Brunner's gland cysts are rare benign lesions that are mainly observed in the first and the second regions of the duodenum. Patients with Brunner's gland cyst demonstrate no specific symptoms. The present study reports the case of a patient with Brunner's gland cyst located in the duodenum in combination with a gastrointestinal stromal tumor (GIST) in the same region. To the best of our knowledge, the present study reports the first case of Brunner's gland cyst with GIST. A 58-year-old female patient was referred to Tianchang Hospital of Traditional Chinese Medicine (Tianchang, China) with a one-month history of upper abdominal discomfort, diarrhea and recurrent vomiting following the intake of food. Upper gastrointestinal endoscopy and a computed tomography scan revealed the presence of a round, cystic-like lesion with internal low density located within the duodenum. Pathological examination revealed that the cyst measured 0.3 cm in diameter and was consistent with a diagnosis of Brunner's gland cyst. Histopathology revealed that the cyst possessed characteristics of GIST. The patient underwent surgical exploration and tumor resection, and was discharged 2 weeks post-surgery. During the 12 month post-operative follow-up period, the outcome of the patient was good. This case study of Brunner's gland cyst combined with GIST enriches the present literature and promotes better understanding of the two diseases. Further investigation is required to explain the mechanism and association between the two rare diseases.
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Affiliation(s)
- Xiqian Huo
- Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Jishu Wei
- Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Xinchun Liu
- Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Junli Wu
- Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Wentao Gao
- Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Qiang Li
- Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Kuirong Jiang
- Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Cuncai Dai
- Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Y I Miao
- Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
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14
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Wei JM, Zhang ZZ, Shen YY, Shen DP, Ni XZ. A rare gastric neuroendocrine carcinoma coexisting with Brunner's gland adenoma: A case report. Oncol Lett 2015; 10:1251-1254. [PMID: 26622658 DOI: 10.3892/ol.2015.3465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 01/22/2015] [Indexed: 11/06/2022] Open
Abstract
Gastric neuroendocrine carcinoma (G-NEC) is a rare neoplasm known for its aggressive behavior and poor prognosis. Brunner's gland adenoma (BGA) is a rare benign proliferative lesion that develops most commonly in the duodenum. To the best of our knowledge, no cases of G-NEC coexisting with BGA have previously been reported. The present study therefore reports the first case of G-NEC combined with BGA. A 67-year-old female presented with upper abdominal discomfort. No distant metastases were detected upon pre-operative abdominal computed tomography imaging. The patient underwent a radical distal gastrectomy, D2 lymphadenectomy and Billroth I gastroenterostomy. The resected masses were histologically confirmed to be G-NEC and BGA, respectively. The patient did not receive neoadjuvant or adjuvant chemotherapy or radiotherapy, and remains alive with no evidence of metastasis or recurrence at four years post-surgery.
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Affiliation(s)
- Jian-Ming Wei
- Department of General Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, P.R. China
| | - Zi-Zhen Zhang
- Department of General Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, P.R. China
| | - Yan-Ying Shen
- Department of General Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, P.R. China
| | - Dan-Ping Shen
- Department of General Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, P.R. China
| | - Xing-Zhi Ni
- Department of General Surgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, P.R. China
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15
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Abstract
Brunner's gland hamartoma (BGH) is a rare benign tumour of the duodenum. We present a case of duodenal obstruction caused by a BGH, which required surgical resection after a failed attempt at endoscopic removal.
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Affiliation(s)
- J Sedano
- East and North Hertfordshire NHS Trust , UK
| | - R Swamy
- East and North Hertfordshire NHS Trust , UK
| | - K Jain
- East and North Hertfordshire NHS Trust , UK
| | - S Gupta
- East and North Hertfordshire NHS Trust , UK
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16
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Verma I, Jha R, Parikh M, Agrawal A. Giant Brunner's gland hamartoma! BMJ Case Rep 2015; 2015:bcr-2015-210670. [PMID: 26109636 DOI: 10.1136/bcr-2015-210670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Isha Verma
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA
| | - Ruchi Jha
- Department of Pathology, Monmouth Medical Center, Long Branch, New Jersey, USA
| | - Manan Parikh
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA
| | - Abhinav Agrawal
- Department of Internal Medicine, Monmouth Medical Center, Long Branch, New Jersey, USA
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17
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Takeuchi M, Cho H, Sugimoto M, Ohira T, Usuki N, Morimoto Y. CT and MRI findings for Brunner’s gland hamartoma: report of three cases. Jpn J Radiol 2015; 33:375-9. [DOI: 10.1007/s11604-015-0425-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 04/15/2015] [Indexed: 11/30/2022]
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18
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Houwers JB, de Bie SH, Hofstee N. AIRP best cases in radiologic-pathologic correlation: Brunner gland hamartoma. Radiographics 2012; 32:213-8. [PMID: 22236902 DOI: 10.1148/rg.321105233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Janna Berendina Houwers
- Department of Radiology and Pathology, Deventer Ziekenhuis, Nico Bolkesteinlaan 75, 7416 SE Deventer, the Netherlands.
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Giant Brunner's gland adenoma as an unusual cause of anaemia: report of a case. Radiol Oncol 2011. [PMID: 22933946 DOI: 10.2478/v10019-010-0053-5.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Brunner's gland adenoma (BGA) is a rare benign duodenal tumour proliferating from Brunner's glands. Here, we present a giant BGA leading to anaemia, with its clinical, endoscopic, radiological, surgical and pathological findings. CASE REPORT A 48-year-old Turkish man complained of a six months history of vague epigastric discomfort, loss of appetite and nausea after meals without vomiting. The physical examination had no unremarkable finding. Laboratory findings, including liver function tests, were within normal limits except a hypochromic, microcytic anaemia. The upper gastrointestinal endoscopic examination revealed a lobulated, red, polypoid tumour with a smooth surface covered with normal mucosa. The tumour was located on the anterior surface of duodenal bulb and had a wide base measuring 3.5 × 4 cm in size. Endoscopic ultrasonography revealed a submucosal polypoid mass located at the anterior surface of duodenal bulb. The endoscopic excision was tried but was not successful. The patient was operated and transduodenal polypectomy was done. The postoperative period was uneventful and the pathologic diagnosis was assessed as Brunner's gland adenoma. During the follow-up period, the endoscopic examination was normal at 12th month postoperatively. CONCLUSIONS BGA is a rare benign cause of anaemia that can be treated with excellent results.
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Coskun A, Erkan N. Giant Brunner's gland adenoma as an unusual cause of anaemia: report of a case. Radiol Oncol 2011; 45:129-31. [PMID: 22933946 PMCID: PMC3423726 DOI: 10.2478/v10019-010-0053-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2010] [Accepted: 09/14/2010] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Brunner's gland adenoma (BGA) is a rare benign duodenal tumour proliferating from Brunner's glands. Here, we present a giant BGA leading to anaemia, with its clinical, endoscopic, radiological, surgical and pathological findings. CASE REPORT A 48-year-old Turkish man complained of a six months history of vague epigastric discomfort, loss of appetite and nausea after meals without vomiting. The physical examination had no unremarkable finding. Laboratory findings, including liver function tests, were within normal limits except a hypochromic, microcytic anaemia. The upper gastrointestinal endoscopic examination revealed a lobulated, red, polypoid tumour with a smooth surface covered with normal mucosa. The tumour was located on the anterior surface of duodenal bulb and had a wide base measuring 3.5 × 4 cm in size. Endoscopic ultrasonography revealed a submucosal polypoid mass located at the anterior surface of duodenal bulb. The endoscopic excision was tried but was not successful. The patient was operated and transduodenal polypectomy was done. The postoperative period was uneventful and the pathologic diagnosis was assessed as Brunner's gland adenoma. During the follow-up period, the endoscopic examination was normal at 12th month postoperatively. CONCLUSIONS BGA is a rare benign cause of anaemia that can be treated with excellent results.
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Affiliation(s)
- Ali Coskun
- Department of Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
| | - Nazif Erkan
- Department of Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
- Department of Emergency Medicine, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
- Correspondence to: Assoc. Prof. Nazif Erkan MD, 2040/5 Sok. No: 8 Flamingo 9 D.39 Mavişehir-Karşıyaka İzmir, Turkey. Phone: +90 505 5307807, Fax: +90 232 2277201; E-mail:
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de la Riva S, Carrascosa J, Muñoz-Navas M, Súbtil JC, Carretero C, Sola JJ, Hernández-Lizoain JL. [Giant Brunner's gland hamartoma: diagnosis and endoscopic treatment]. GASTROENTEROLOGIA Y HEPATOLOGIA 2011; 34:333-6. [PMID: 21477891 DOI: 10.1016/j.gastrohep.2011.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 02/03/2011] [Accepted: 02/13/2011] [Indexed: 11/25/2022]
Abstract
Brunner's gland hamartoma is a polypoid lesion typically composed of an increased quantity of normal-appearing Brunner's glands, accompanied by a variable proportion of smooth muscle. Most of these masses are asymptomatic and behave as benign tumors. Occasionally tumoral growth can provoke gastrointestinal problems which, together with the possibility of malignant transformation, will require resection after a broad differential diagnosis has been made with solitary duodenal mass. Both clinical and radiographic studies are nonspecific and often do not allow diagnosis of these tumors. Basic endoscopic studies (upper endoscopy) with adequate characterization of the lesion by endoscopic ultrasound (EUS) can establish a high diagnostic suspicion and determine the best therapeutic option (endoscopy or surgery). We present a case of giant Brunner's gland hamartoma. The initial manifestation was iron-deficiency anemia with no evidence of bleeding. After adequate characterization of the lesion, EUS allowed complete and safe endoscopic resection, avoiding more invasive surgical treatment.
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Affiliation(s)
- Susana de la Riva
- Servicio de Cirugía General, Clínica Universidad de Navarra, Navarra, España.
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Carboni F, Valle M, Garofalo A, Mariantonia C. Laparoscopic Excision of a Symptomatic Brunneroma. Am Surg 2011. [DOI: 10.1177/000313481107700207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Reichenbach-Klinke E, Miksch T, Orner R, Bergelt S, Sterk P. [Hamartoma of the duodenum: a rare cause of gastrointestinal bleeding]. Chirurg 2010; 81:1115-7. [PMID: 20428835 DOI: 10.1007/s00104-010-1925-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We report on a 34-year-old man who was admitted to our hospital with melena and hematemesis. Endoscopy showed a giant pedunculated polyp of the duodenum as the source of bleeding. The 10 cm long tumor was resected transduodenally by open surgery and the histological examination revealed it to be a hamartoma. This case demonstrates a very rare benign tumor of the duodenum, its possible clinical manifestation and treatment options.
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Affiliation(s)
- E Reichenbach-Klinke
- Urologische Abteilung, Klinikum Kempten Oberallgäu, Robert-Weixler-Strasse 50, 87439, Kempten, Deutschland.
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