A giant Brunner gland hamartoma successfully treated by endoscopic excision followed by transanal retrieval: A case report.

Published on Apr 9, 2021in Medicine1.552
· DOI :10.1097/MD.0000000000025048
Motonobu Maruo (Kansai Medical University), Tomomitsu Tahara2
Estimated H-index: 2
(Kansai Medical University)
+ 13 AuthorsMakoto Naganuma36
Estimated H-index: 36
(Kansai Medical University)
RATIONALE Brunner gland hamartoma (BGH) is a rare tumor of the duodenum. Although BGH is a benign tumor, larger lesion with gastrointestinal symptoms requires tumor removal. We report a giant BGH, successfully treated by endoscopic excision followed by transanal retrieval. PATIENT CONCERNS A 38-year-old woman complained of severe anemia, tarry stool, and vomiting. DIAGNOSES Esophagogastroduodenoscopy (EGD) showed a pedunculated giant submucosal mass at the duodenal bulb. INTERVENTIONS We attempted to remove it because the lesion seemed to be responsible for patient's anemia and vomiting. The lesion had clear but bulky stalk. We carefully cut the stalk using needle-knife and IT knife2. We tried to retrieve specimen, but the mass could not pass through the pyloric ring because of its size. Then we tried to obtain the specimen from anus. Polyethylene glycol solution was administered to accelerate rapid excretion. OUTCOMES The mass was successfully removed and was histologically confirmed as a giant BGH, measuring 55 mm in size. LESSONS Reports about endoscopic resection of giant BGH are rare. Moreover, our case is the first report of transanal retrieval of resected specimen using polyethylene glycol solution. Endoscopic resection of BGH is less-invasive but can be more challenging if the mass is large. Our case provides useful option for endoscopic treatment of giant BGH.
#1Lizhi YiH-Index: 1
#2Zhengyu ChengH-Index: 1
Last. Ke LiuH-Index: 1
view all 6 authors...
Background With the development and application of endoscopic technology, most pedunculated polyps can be absolutely resected with a complete specimen by hot snare polypectomy (HSP). Brunner’s gland hamartoma (BGH) is a rare benign small bowel tumor. The majority of BGH measuring about 2 cm in diameter, rarely larger than 5 cm. Most patients are asymptomatic, some may present with gastrointestinal hemorrhage or intestinal obstruction. Symptomatic larger lesions leading to bleeding or obstruction...
3 CitationsSource
#1Yusuke Kitagawa (JFCR: Japanese Foundation for Cancer Research)H-Index: 2
#2Hiroki Osumi (JFCR: Japanese Foundation for Cancer Research)H-Index: 11
Last. Junko Fujisaki (JFCR: Japanese Foundation for Cancer Research)H-Index: 27
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Abstract We describe a patient with a giant Brunner’s gland hamartoma in the duodenum who was safely treated by endoscopic mucosal resection (EMR). A 64-year-old woman visited our hospital for a workup of severe anaemia (haemoglobin level: 5 g/dL). Oesophagogastroduodenoscopy revealed a large pedunculated and elongated polypoid lesion measuring approximately 70 mm in longitudinal diameter, located at the anterior wall of the duodenal bulb. We diagnosed her as having gastrointestinal bleeding ori...
3 CitationsSource
#1Nicola FrenkelH-Index: 4
#2Miangela M. LacleH-Index: 12
Last. Jeroen HagendoornH-Index: 18
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Brunner’s gland hamartoma, also called hyperplasia, adenoma, and Brunneroma, is an extremely rare benign proliferative lesion of Brunner’s glands in the duodenum. While being mostly small and asymptomatic, they can result in gastrointestinal bleeding and obstruction. We report the case of a 54-year-old man presenting with melena and severe anemia requiring blood transfusion. CT scans showed a large mass of 8 cm in diameter, presumably arising in the duodenum. Endoscopic biopsies were not conclus...
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#1Anshuman PandeyH-Index: 2
#2Abhijit ChandraH-Index: 13
Last. Anup Kumar WahalH-Index: 1
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Duodenal adenoma presenting with duodenojejunal intussusception is very rare. Only a few have ever been reported. Upon evaluation it may be difficult to rule out malignancy. The final diagnosis may be reached only at surgery and confirmed at histopathology.
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#1Nandini Patel (MedStar Washington Hospital Center)H-Index: 3
#2Angela D. LevyH-Index: 34
Last. Leslie H. SobinH-Index: 95
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OBJECTIVE. The purpose of this essay is to describe, illustrate, and correlate the imaging and pathologic features of Brunner's gland hyperplasia and Brunner's gland hamartoma.CONCLUSION. This article summarizes our experience with pathologically proven cases of Brunner's hyperplasia and hamartoma accessioned into the radiologic pathology archive of the Armed Forces Institute of Pathology.
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#1William Mayoral (GUMC: Georgetown University Medical Center)H-Index: 5
#2J. A. Salcedo (Georgetown University)H-Index: 5
Last. Firas H. Al-Kawas (Georgetown University)H-Index: 26
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#1James A. Levine (Mayo Clinic)H-Index: 77
#2Lawrence J. Burgart (Mayo Clinic)H-Index: 91
Last. Kenneth K. Wang (Mayo Clinic)H-Index: 81
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Objectives: The aim of this study was to characterize the clinical presentation, pathological features, and outcome of a series of patients with Brunner's gland hamartomas. Methods: We reviewed the clinical and pathological features of 27 patients who presented with Brunner's gland hamartomas, and we obtained follow-up information. Results: patients (12 men and 15 women) presented predominantly in the fifth and sixth decades of life either with gastrointestinal hemorrhage (n=10) or obstructive s...
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