A case of Brunner's gland hyperplasia with features of duodenal cancer

Abstract

A rare case of Brunner's gland hyperplasia mimicking duodenal cancer is reported. A 68-year old woman had an elevated lesion in the second portion of the duodenum. Endoscopy after spraying with indigo carmine dye showed a granular appearance and fold convergence. The biopsy specimen suggested hyperplasia without malignancy. However, since the endoscopic features strongly suggested malignancy, endoscopic mucosal resection (EMR) was performed to establish the correct diagnosis. The final pathology diagnosis was Brunner's hyperplasia.

Brunner's gland hyperplasia and recurrent gastric impaction in a horse

“…[11][12][13] In medical literature, Brunner's gland hyperplasia most commonly manifests as a focal, often pedunculated, nodule or polyp within the duodenal lumen; however there are rare reports of a more focally extensive nodular thickening as the presentation. 14,15 Brunner's gland hyperplasia is often an incidental finding on gastrointestinal endoscopy in human medicine; clinical signs are more commonly associated with larger masses with obstruction being seen in masses greater than 2.1 cm. 16 In horses, Brunner's gland hyperplasia has previously only been described as a multifocal nodular thickening of the duodenal mucosa.…”

Pyloric Giant Brunner?s Gland Adenoma Mimicking Duodenal Carcinoma

“…Useful diagnostic tools of Brunner's gland adenoma are barium contrast studies, abdominal CT and endoscopy [8,12], however sensitivity of endoscopy is 72-89 % and occasionally, endoscopy is not useful in making the diagnosis [12]. Endoscopic punch biopsy usually gives a negative result, because the tumor is almost entirely covered with thick intact duodenal mucosa in the biopsy sites and the biopsy is often not deep enough to reach the submucosal tumor [2,8,12]. The giant variety is diagnostically challenging due to its large size.…”