Obstructive Jaundice Secondary to Carcinoma Arising in Brunner's Glands

Abstract

a connection between pathological processes and the pigmentation must be restricted to cases with greater than the normal age-related deposition of ceroid pigment".5 Large amounts of lipofuscin have been demonstrated in the livers of patients following excessive intake of phenacetin"6, but not to date in patients taking either ketoprofen or azathioprine. The histological and electron microscopy findings in the case rule out diffuse disease and, by exclusion, strongly suggest a focal pattern of hepatic necrosis. References 1 Urowitz MB, Gordon DA, Smythe HH. Azathioprine treatment of rheumatoid arthritis: a double blind cross-over study.

A Case of Brunner Gland Adenoma, which Exhibited Dramatic Macroscopic Metamorphosis in 2 Years without Canceration

“…BGH or BGA was once not believed to undergo malignant degeneration [7] but the cases complicated with malignancy have been reported [5,[8][9][10][11][12][13]. Since macroscopic transformation of BGA in the natural history is considered indicating canceration within, it is proposed as the hallmark of malignant degeneration advocating endoscopic or surgical intervention [10,12].…”

“…Though canceration of them was once questioned [7], such very rare cases have been published [5,[8][9][10][11][12][13] and a definite association was reported of macroscopic transformation of the latter in the natural history with development of malignancy [10,12]. This report presents a case of BGA, which showed dramatic macroscopic metamorphosis during a 2 year-period but was revealed to harbor no carcinoma.…”

Giant Brunner’s Hamartomas of the Duodenum and Obstructive Jaundice

“…Two unique cases have been presented in the literature in which intestinal obstruction was caused by intussusceptions of the duodenal wall by hamartoma migration [3]. Additionally, 3 cases of bile duct obstruction have been described in combination with BGHs [2]. In these rare cases no clear explanation is given however.…”

“…These tumors are discovered incidentally as an abnormal cause of duodenal obstruction or due to bleeding, but not as a cause of obstructive jaundice [2, 3]. …”

Noninvasive Adenocarcinoma in Brunner’s Gland Hyperplasia Occurring in the Third Portion of the Duodenum

“…The incidence of this tumor is exceedingly low in the por tion distal to papilla of Vater [5,6]. In addition, adenocar cinoma of Brunner's gland origin has rarely been reported [7][8][9][10][11][12][13][14][15][16][17]; however, it is doubtful whether Brunner's glands are the site of origin and the view of malignant transfor mation has not been fully substantiated. We report herein a case of noninvasive adenocarcinoma derived from Brunner's gland hyperplasia, occurring in the third por tion of the duodenum, together with the results of immu nohistochemical and ultrastructural studies.…”