A CASE OF SUBMUCOSAL TUMOR IN THE DUODENAL BULB IS REPORTED DUE TO BRUNNER’S GLAND HYPERPLASIA

Cao Nhat Linh Nguyen1,, Hieu Tam Huynh2
1 Can Tho University of Medicine and Pharmacy Hospital
2 Can Tho University of Medicine and Pharmacy

Main Article Content

Abstract

Brunner's glands are the exocrine glands located in the submucosa of the duodenum. Brunner’s gland hyperplasia is a rare and benign lesion of the duodenum that was first described in 1835. Most Brunner’s gland hyperplasia patients are asymptomatic and are discovered incidentally through the endoscopy with the image of submucosal tumors. Brunner's gland hyperplasia can be treated by local endoscopic resection or surgery. We reported a case in July 2023, a 63-year-old female patient came to the clinic with frequent indigestion, poor appetite and abdominal pain. After being indicated for upper gastrointestinal endoscopy, a submucosal tumor, which is about 18mm in diameter, was detected. We successfully performed endoscopic intervention to cut the submucosal tumor, stop the bleeding and close the cut with the clips. Biopsy of submucosal tumor showed the result of Brunner's gland hyperplasia (hamartoma).

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References

1. Robert D. Odze and John R. Goldblum. Surgical Pathology of the GI Tract, Liver, Biliary Tract, and Pancreas. Saunders Elsevier. Philadelphia. 2009. 2.
2. Levine J.A, Burgart L.J, Batts K.P and Wang K.K. Brunner's gland hamartomas: Clinical presentation and pathological features of 27 cases. American Journal of Gastroenterology. 1995. 90(2), 290-294.
3. Spellberg MA and Vucelic B. A case of Brunner’s glands hyperplasia with diarrhea responsive to cimetidine. Am J Gastroenterol. 1980. 73 (6), 519-522.
4. Kovacevic I, Ljubicic N, Cupic H, Doko M, Zovak M and et al. Helicobacter pylori infection in patients with Brunner’s gland adenoma. Acta Med Croatica. 2001. 55(4-5), 157–160.
5. Andrea Peloso, Jacopo Vigano, Alessandro Vanoli, Tommaso Dominioni, Sandro Zont and et al. Saving from unnecessary pancreaticoduodenectomy. Brunner's gland hamartoma: Case report on a rare duodenal lesion and exhaustive literature review. Annals of Medicine and Surgery. 2017. 17, 43-49, DOI: 10.1016/j.amsu.2017.03.034.
6. Domenico Iusco, Luigi Roncoroni, Vincenzo Violi, Enrico Donadei and Leopoldo Sarli. Brunner's gland hamartoma: 'over-treatment' of a voluminous mass simulating a malignancy of the pancreatic-duodenal area. Journal of the Pancreas. 2005. 6(4), 348-353.
7. Reisner R.M and Nava H.R. Large Brunner's gland hamartoma simulating a pancreatic mass with obstruction and bleeding. Surg Endosc. 1996. 10(3), 341-343, DOI: 10.1007/BF00187387. 8. Monica Arena, Stefania Rossi, Elisabetta Morandi, Benedetto Mangiavillano and Paolo Franchi. Brunner's glands hyperplasia: Diagnosis with EUS-FNA for suspected pancreatic tumor involving the duodenum. Journal of the Pancreas. 2012. 13 (6), 684-686, DOI: 10.6092/15908577/970.
9. Dhouha B, Ahlem L, Sana B.S., Saadia B and Sabeh M.R. Unexpected cause for duodenal obstruction: Brunner's gland hyperplasia. Pathologica. 2017. 109(4), 414-417.
10. Jonathan McCafferty, Ashraf Tokhi, Sujith Krishnamoorthy and Girish Pandeb. Case report of
Brunner’s gland hyperplasia: A rare “mimic” of malignant pathology. International Journal of Surgery Case Reports. 2021. 81, DOI: 10.1016/j.ijscr.2021.105827.
11. Costa-Pinho A, Pinto-de-Sousa J, Baptista M, Rios E, Moura CS and et al. Brunner's gland hyperplasia: an unusual cause of hemorrhagic shock. J Surg Case Rep. 2011. 5, 1-5, DOI:
10.1093/jscr/2011.5.2.