Brunner's gland adenoma of duodenum: A case report and literature review

Department of Pathology, Affiliated Renji Hospital, Shanghai Second Medical University, 145 Shandong (c) Road, Shanghai 200001, China.
World Journal of Gastroenterology (Impact Factor: 2.37). 10/2004; 10(17):2616-7.
Source: PubMed


To analyze the clinicopathological features of Brunner's gland adenoma of the duodenum.
A rare case of Brunner's gland adenoma of the duodenum was described and related literature was reviewed.
Brunner's gland adenoma of the duodenum appeared to be nodular hyperplasia of the normal Brunner's gland with an unusual admixture of normal tissues, including ducts, adipose tissue and lymphoid tissue. We suggested that it might be designated as a duodenal hamartoma rather than a true neoplasm.
The most common location of the lesion is the posterior wall of the duodenum near the junction of its first and second portions. It can result in gastrointestinal hemorrhage and duodenal obstruction. Endoscopic polypectomy is a worthy treatment for benign Brunner's gland adenomas, as malignant changes in these tumors have never been proven.

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Available from: Yu Ping Gao, Nov 06, 2014
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    • "The hemorrhagic manifestations due to ulceration or erosion of the tumor are melena, fatigue, anemia and rarely hematemesis [8]. Obstruction occurs when the hyperplasia is diffuse or a single adenoma grows too large, causing epigastric bloating, pain, nausea, vomiting and weight loss [9]. Patients with tumor-related obstructive complications tend to have hamartomas ≥2 cm [10]. "
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    ABSTRACT: Brunner's gland hamartoma is a rare benign small bowel neoplasm and most lesions are small and asymptomatic. However, large hamartoma-related obstructive symptoms and hemorrhage related to tumor ulceration manifest as hematemesis or melena. The exact pathogenesis if these lesions is not well known, but they are thought to be frequently associated with Helicobacter pylori infections and chronic pancreatitis. We report the case of a 45-year-old man who presented with melena due to a large pedunculated Brunner's gland hamartoma arising from the pylorus. It was successfully removed by endoscopic mucosal resection with piecemeal technique because of too large tumor size for application of a conventional snare.
    Case Reports in Gastroenterology 05/2013; 7(2):304-7. DOI:10.1159/000354138
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    ABSTRACT: L’hamartome brunnerien correspond à une tumeur bénigne et rare du duodénum pouvant être responsable d’hémorragie digestive ou d’occlusion digestive haute. Le traitement était auparavant chirurgical, mais l’avancée des techniques d’endoscopie permet maintenant d’envisager une exérèse endoscopique. Nous décrivons le cas d’un hamartome brunnerien géant découvert de façon fortuite et son aspect typique hypodense dont l’exérèse endoscopique a pu être réalisée avec succès par polypectomie à l’anse diathermique après mise en place d’une anse détachable. Nous décrivons les aspects spécifiques de l’hamartome malgré sa dénomination courante d’adénome brunnerien. Brunner’s gland hamartoma (BGH) is an uncommon, benign tumour of the duodenum that can cause bleeding in the digestive tract or blockage of the upper digestive tract. Until now, surgery was always the treatment used, but advances in endoscopic techniques now make it possible to consider endoscopic resection. We here describe the case of a giant Brunner’s gland hamartoma of typically hypodense appearance, which was discovered fortuitously and successfully removed by endoscopic polypectomy using a diathermic snare with a detachable loop. We describe the specific features of a hamartoma, despite the usual use of the term “Brunner’s gland adenoma”.
    Acta Endoscopica 06/2009; 39(3):175-178. DOI:10.1007/s10190-009-0026-y · 0.16 Impact Factor
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