Large Brunner’s Gland Hyperplasia with Bleeding: A Case Report

We report a rare case of a large Brunner’s gland hyperplasia (BGH) with severe anemia. A 33-year-old woman was transferred to our hospital with anemia and a duodenal mass. She had a 2-week history of melena and mild shortness of breath. Her hemoglobin level was 4.9 g/dl, and she required a blood transfusion. Abdominal computed tomography revealed a 7 cm tumor in the descending duodenum, and duodenoscopy revealed a polyp-like tumor with an ulcer at the duodenal bulb. We decided to perform surgery to prevent further bleeding. Intraoperatively, the tumor stalk was located at the anterior wall of the duodenal bulb; the ampulla was not involved, and we resected the tumor with the wall of the duodenal bulb. The resected tumor measured 7.0 × 4.0 × 2.3 cm , and pathologically, the tumor consisted of proliferated Brunner’s glands in a small amount of fibrous stroma. The histological diagnosis was BGH with no malignancy. Most cases of BGH are benign and asymptomatic; however, it is important to be aware that some patients have severe anemia, gastrointestinal obstruction, or malignant potential.

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En Bloc Endoscopic Resection of Large Pedunculated Brunner’s Gland Hamartoma: A Case Report

Case Reports in Gastroenterology ◽

10.1159/000490098 ◽

2018 ◽

Vol 12 (2) ◽

pp. 344-351

Author(s):

Annalisa Pasetti ◽

Elvira Capoferro ◽

Giulia Querzoli ◽

Renzo Montanari ◽

Paolo Bocus

Keyword(s):

Endoscopic Resection ◽

Epigastric Pain ◽

Duodenal Bulb ◽

Anterior Wall ◽

Upper Gastrointestinal Endoscopy ◽

En Bloc ◽

Brunner’S Gland ◽

Brunner's Gland ◽

Brunner’S Gland Hamartoma ◽

Submucosal Lesion

Brunner’s gland hamartoma (BGH) is an uncommon benign tumor arising from alkaline-based mucin-secreting glands of the duodenum. These lesions are typically discovered incidentally during upper gastrointestinal endoscopy or radiological diagnostics, even though they can eventually lead (in the case of increasing size) to obstructive or hemorrhagic symptoms. We report the case of a 67-year-old Caucasian man with two episodes of melena and epigastric pain during the last month. Esophagogastroduodenoscopy revealed a large pedunculated and eroded polyp inside the antrum with a 2-cm-long stalk arising from the anterior wall of the duodenal bulb. Endoscopic ultrasonography showed a submucosal lesion with homogeneous hyperechoic parietal thickening and some central gaps. The muscularis was undamaged. No lymphadenopathy was observed. We performed an en bloc endoscopic resection of the polyp. The size of the whole piece was approximately 6 × 3 × 2 cm, pseudocapsulated and tough in consistency. In the case presented, the en bloc endoscopic removal was successful despite the size of the tumor.

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Giant Brunner’s Gland Hamartoma of the Duodenal Bulb Presenting with Upper Gastrointestinal Bleeding and Obstruction

Clinical Endoscopy ◽

10.5946/ce.2016.022 ◽

2016 ◽

Vol 49 (6) ◽

pp. 570-574 ◽

Cited By ~ 1

Author(s):

Ju Hyoung Lee ◽

Kyeong Min Jo ◽

Tae Oh Kim ◽

Jong Ha Park ◽

Seung Hyun Park ◽

...

Keyword(s):

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Duodenal Bulb ◽

Brunner’S Gland ◽

Brunner's Gland ◽

Brunner’S Gland Hamartoma ◽

Upper Gastrointestinal

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A great Brunner's gland adenoma of the duodenal bulb

Digestive Diseases and Sciences ◽

10.1007/bf01296867 ◽

1984 ◽

Vol 29 (1) ◽

pp. 81-85 ◽

Cited By ~ 14

Author(s):

Toru Nakanishi ◽

Tadashi Takeuchi ◽

Kazuo Hara ◽

Akitoshi Sugimoto

Keyword(s):

Duodenal Bulb ◽

Brunner’S Gland ◽

Brunner's Gland

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Large Brunner’s gland adenoma of the duodenum for almost 10 years

Open Life Sciences ◽

10.1515/biol-2020-0029 ◽

2020 ◽

Vol 15 (1) ◽

pp. 237-240

Author(s):

Bo Yang ◽

Ke Li ◽

Runlan Luo ◽

Zuming Xiong ◽

Lianwei Wang ◽

...

Keyword(s):

Benign Tumor ◽

Accurate Diagnosis ◽

Case Presentation ◽

Brunner's Glands ◽

Gastrointestinal Obstruction ◽

Brunner’S Glands ◽

Rare Benign Tumor ◽

Brunner’S Gland ◽

Brunner's Gland ◽

Upper Gastrointestinal

AbstractBackgroundBrunner’s gland adenoma is a rare benign tumor arising from Brunner’s glands. It is mostly small in size, and patients with this tumor are asymptomatic.Case presentationWe report the case of a 63-year-old woman with upper gastrointestinal obstruction for almost 10 years, who was pathologically diagnosed with large Brunner’s gland adenoma of the duodenum. Postoperatively, no sign of recurrence has been noted until now.ConclusionThis study may help clinicians to understand and provide a more accurate diagnosis of Brunner’s gland adenoma.

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A CASE OF BRUNNER'S GLAND HYPERPLASIA IN THE DUODENAL BULB

The journal of the Japanese Practical Surgeon Society ◽

10.3919/ringe1963.53.1897 ◽

1992 ◽

Vol 53 (8) ◽

pp. 1897-1901

Author(s):

Hiroaki HARUGUCHI ◽

Hiroshi HONDA ◽

Taketoshi HAYASHI ◽

Tomoaki HOSHINO ◽

Sumihiko SATOH ◽

...

Keyword(s):

Duodenal Bulb ◽

Brunner’S Gland ◽

Brunner's Gland

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Resección endoscópica de hamartoma gigante de glándulas de Brunner. Reporte de un caso

Acta gastroenterológica latinoamericana ◽

10.52787/gput6166 ◽

2021 ◽

Vol 51 (3) ◽

Author(s):

Karina Yonamine ◽

Cecilia Curvale ◽

Raul Matanó ◽

Alejandro Hensel ◽

María Fernanda Yankowyez

Keyword(s):

Histopathological Examination ◽

Duodenal Bulb ◽

Malignant Neoplasm ◽

Benign Neoplasm ◽

Duodenal Wall ◽

Large Size ◽

Brunner’S Gland ◽

Low Incidence ◽

Brunner's Gland ◽

Brunner’S Gland Hamartoma

Brunner's gland hamartoma or hyperplasia is a rare benign neoplasm of the small intestine, usually small, that is discovered incidentally on an upper digestive endoscopy or imaging tests. When it reaches a large size, it can cause digestive bleeding or intestinal obstruction. The pathogenesis is unknown. The endoscopic presentation can be nodular, polypoid or a diffuse glandular proliferation with thickening of the duodenal wall, and may be mistaken for a malignant neoplasm. Endoscopic resections of large Brunner's gland hamartomas in the duodenum is little reported in literature, due to its low incidence and diagnostic difficulty. The surgical approach is associated to greater morbidity compared to an endoscopic approach. The case of a 62-year-old patient is reported, who presented melena and symptomatic anemia, secondary to a giant polyp in the duodenal bulb. The polyp was successfully resected endoscopically without complications, which made it possible to avoid a more extensive surgical procedure. Histopathological examination of the whole specimen showed a Brunner's gland hamartoma. Conclusion: Brunner's gland hyperplasia or hamartoma is a benign neoplasm that rarely produces symptoms. Large lesions can become symptomatic and a high clinical-endoscopic suspicion and an evaluation of the extension are necessary before applying any therapeutic procedure, in order to avoid complex surgeries and favor a complete and safe endoscopic resection.

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