Brunner’s Gland Hamartoma of the Duodenum: A Literature Review

Abstract

Brunner's gland hamartoma is a benign tumor of the duodenum, but has malignant potential with a very low risk of progression into adenocarcinoma. It is uncommon with a frequency of less than 1.0% among the primary tumors of the small intestine. In addition, its clinical manifestations are nonspecific, etiology remains unclear, and treatment strategy needs to be further refined. This literature review mainly discusses the epidemiology, clinical features, possible etiology and pathogenesis, diagnostic methods, malignant potential, treatment, and prognosis of Brunner's gland hamartoma.

Brunner’s gland hyperplasia associated with lipomatous pseudohypertrophy of the pancreas presenting with gastrointestinal bleeding: A case report

“…BGH of the duodenum belongs to the spectrum of benign Brunner’s gland proliferations, which are variously termed as BGH, Brunner’s gland adenoma, and Brunner’s gland hamartoma. However, the distinction between these diagnoses is obscure and the terms are used interchangeably in the literature[ 2 , 13 , 14 ]. Histologically, several authors have classified benign Brunner’s gland proliferations based on their tissue components.…”

“…Benign proliferations in Brunner’s glands account for 5%–10% of benign duodenal masses and < 1% of primary small intestinal tumors[ 2 , 13 , 14 , 17 ]. BGH was found in 0.3% among patients who undergo upper gastrointestinal endoscopy[ 2 , 17 ].…”

“…Benign proliferations in Brunner’s glands account for 5%–10% of benign duodenal masses and < 1% of primary small intestinal tumors[ 2 , 13 , 14 , 17 ]. BGH was found in 0.3% among patients who undergo upper gastrointestinal endoscopy[ 2 , 17 ]. These proliferative lesions may manifest as solitary or multiple nodules, appearing as sessile or polypoid masses in most cases.…”

“…However, much larger lesions measuring up to 120 mm have been reported[ 19 ]. Clinically, most BGHs are asymptomatic, incidentally found in patients at the age of 50–60 years[ 2 , 3 , 15 , 17 ]. In case of symptomatic BGH, the most common presentation is GI bleeding, either hematemesis or melena[ 4 , 5 ], although < 15 cases showing acute hemorrhage have been reported[ 20 , 21 ].…”

“…Brunner’s gland hyperplasia (BGH) is a rare, benign proliferative lesion of exocrine glands mainly located in the submucosal layer of the duodenum[ 1 ]. Most BGHs are asymptomatic[ 2 , 3 ], but some present with abdominal pain, upper gastrointestinal (GI) bleeding and may be associated with obstruction[ 4 - 9 ]. Lipomatous pseudohypertrophy (LiPH) of the pancreas is an extremely rare disease, characterized by the replacement of exocrine pancreatic parenchyma with mature fatty tissue[ 10 , 11 ].…”