Endoscopic resection of a large Brunner's gland hamartoma

Brunner's gland cyst in combination with gastrointestinal stromal tumor: A case report

Brunner's gland cysts are rare benign lesions that are mainly observed in the first and the second regions of the duodenum. Patients with Brunner's gland cyst demonstrate no specific symptoms. The present study reports the case of a patient with Brunner's gland cyst located in the duodenum in combination with a gastrointestinal stromal tumor (GIST) in the same region. To the best of our knowledge, the present study reports the first case of Brunner's gland cyst with GIST. A 58-year-old female patient was referred to Tianchang Hospital of Traditional Chinese Medicine (Tianchang, China) with a one-month history of upper abdominal discomfort, diarrhea and recurrent vomiting following the intake of food. Upper gastrointestinal endoscopy and a computed tomography scan revealed the presence of a round, cystic-like lesion with internal low density located within the duodenum. Pathological examination revealed that the cyst measured 0.3 cm in diameter and was consistent with a diagnosis of Brunner's gland cyst. Histopathology revealed that the cyst possessed characteristics of GIST. The patient underwent surgical exploration and tumor resection, and was discharged 2 weeks post-surgery. During the 12 month post-operative follow-up period, the outcome of the patient was good. This case study of Brunner's gland cyst combined with GIST enriches the present literature and promotes better understanding of the two diseases. Further investigation is required to explain the mechanism and association between the two rare diseases.

[Hamartoma of the duodenum: a rare cause of gastrointestinal bleeding]

We report on a 34-year-old man who was admitted to our hospital with melena and hematemesis. Endoscopy showed a giant pedunculated polyp of the duodenum as the source of bleeding. The 10 cm long tumor was resected transduodenally by open surgery and the histological examination revealed it to be a hamartoma. This case demonstrates a very rare benign tumor of the duodenum, its possible clinical manifestation and treatment options.

Biliary obstruction and pancreatitis caused by diffuse nodular hyperplasia of Brunner's gland

INTRODUCTION

Brunner's gland hyperplasia (BGH) of the duodenum is an uncommon finding at endoscopy and is usually asymptomatic. Symptomatic BGH presenting with biliary obstruction and pancreatitis is extremely rare and the literature is limited to a few case reports.

CASE

We report an unusual case of diffuse BGH of duodenum involving the ampulla of Vater that led to this clinical presentation. Biopsies revealed BGH and successful endoscopic therapy utilizing sphincterotomy and plastic stent placement led to complete recovery.

CONCLUSION

Albeit its uncommon clinical presentation, it can become challenging in terms of diagnosis and management. A high index of suspicion is of paramount importance for establishing the correct diagnosis and treatment.