Endoscopic Resection of Sporadic Non-ampullary Duodenal Neoplasms: A Single Center Study / 대한소화기학회지

BACKGROUND/AIMS: Sporadic non-ampullary duodenal neoplasms are rare and optimal treatment for these lesions remains undefined. Endoscopic resection of duodenal neoplasms is widely used recently and it is an alternative treatment strategy to surgical excision. This study aimed to evaluate the safety and efficacy of endoscopic resection of duodenal neoplasms and to determine its outcomes. METHODS: Patients who underwent endoscopic resection for non-ampullary duodenal neoplasms between January 2005 and December 2014 were analyzed retrospectively. Data including size, morphology, histology, location and endoscopic procedural technique were reviewed. The main outcome measurements were success rate, complication, recurrence and follow-up assessments. RESULTS: The study included 33 patients with duodenal neoplasms. The mean size of resected lesion was 8.58 mm. The results of histologic examination were as follows: 23 (69.7%) adenomas, 2 (6.1%) adenocarcinoma, 3 (9.1%) Brunner's gland tumor and 3 (9.1%) neuroendocrine tumor. Tubular adenoma wase the most common type (63.6%) of non-ampullary duodenal neoplasms. Eighteen (54.5%) lesions were found in the second portion of the duodenum, and 10 (30.3%) lesions on bulb and 3 (9.1%) lesions on superior duodenal angle. Of the 33 cases, 32 (97.0%) were managed by endoscopic mucosal resection technique during a single session and one case was managed by endoscopic submucosal dissection (ESD). One episode of perforation occurred after ESD. During a median follow-up period of 5.76 months, recurrence was observed in only one case of in a patient with tubular adenoma. CONCLUSIONS: Endoscopic resection of duodenal neoplasm is a safe and effective treatment modality that can replace surgical resection in many cases. Careful endoscopic follow-up is essential to manage recurrence or residual lesions.

Large Brunner's gland hamartoma with annular stricture causing gastric outlet obstruction

No abstract available.

Hiperplasia de las glándulas de Brunner: A propósito de 2 casos / Brunners gland hiperplasia: Report of two cases

La hiperplasia de las glándulas de Brunner constituye una lesión benigna infrecuente localizada en la primera o segunda porción duodenal. El espectro de la misma incluye la hiperplasia nodular circunscrita, la difusa y los adenomas de las glándulas de Brunner. Reportamos dos casos, uno con un adenoma de las glándulas de Brunner como un pólipo duodenal y el otro como una hiperplasia nodular difusa del bulbo duodenal.

Brunner’s gland hyperplasia is an infrequent benign injury located on the first or second portion of the duodenum. The disease spectrum includes diffuse nodular hyperplasia, circumscribed nodular hyperplasia, and Brunner’s gland adenoma. We report two cases, one with an adenoma of Brunner’s glands as a duodenal polyp and the other as a diffuse nodular hyperplasia of the duodenal bulb.

Duodenal Brunner's Gland Adenoma Presenting as Subepithelial Tumor with Internal Cystic Portion / 대한소화기학회지

No abstract available.

Endoscopic Resection of a Giant Duodenal Brunner's Gland Adenoma / 대한소화기학회지

Brunner's gland adenoma is a rare tumor of duodenum. Patients are usually aymptomatic and most are discovered incidentally during the upper gastrointestinal (GI) series or esophagogastroduodenoscopy. These lesions are most commonly located in the duodenal bulb and clinical manifestations are variable. In symptomatic patients, the most common manifestations are GI hemorrhage and duodenal obstruction. On histologic examination, Brunner's gland adenoma that causes clinical symptoms is composed of hyperplastic Brunner's glands and contains mostly an admixture of glandular, adipose, and muscular tissues. We report a case of large Brunner's gland adenoma causing upper gastrointestinal hemorrhage in a 47-year-old woman which was successfully removed by endoscopic resection without complications such as bleeding or perforation. Microscopically, it was entirely composed of variable Brunner's glands.

A Case of Giant Brunner's Gland Hyperplasia Combined with Adenomyomatous Hyperplasia / 대한소화기학회지

Brunner's gland hyperplasia is a rare tumor of the duodenum and might also be an unusual cause of gastrointestinal bleeding. In symptomatic patients, treatment requires either surgical resection or endoscopic polypectomy. We report a case of upper gastrointestinal bleeding from a pedunculated Brunner's gland hyperplasia in the duodenal bulb. Endoscopic resection using the detachable snare and hemoclipping was instituted to remove a large pedunculated polyp. The pathologic diagnosis was Brunner's gland hyperplasia with adenomyomatous hyperplasia.

Brunnera's Gland Hyperplasia: Treatment of Severe Diffuse Nodular Hyperplasia Mimicking a Malignancy on Pancreatic-Duodenal Area

Brunnera's gland hyperplasia is a benign tumor of the duodenum and it is rarely associated with clinical symptoms. We report on a 64-yr-old man with Brunnera's gland hyperplasia who had undergone a duodenocephalo-pancreatectomy. The reason is that he presented upper gastrointestinal obstructive symptoms and the esophagogastroduodenoscopic finding revealed the lesion to be an infiltrating type mass on the second portion of the duodenum with luminal narrowing. An abdominal computed tomography showed a 2.5 cm-sized mass in the duodenal second portion with a suspicious pancreatic invasion and 7 mm-sized lymph node around the duodenum. Duodenocephalopancreatectomy was successfully performed. Histological examination revealed a Brunnera's gland hyperplasia. The final diagnosis was the coexistence of Brunnera's gland hyperplasia and pancreatic heterotopia with a pancreatic head invasion. The literature on Brunnera's gland hyperplasia is reviewed.

Brunner's gland hyperplasia at the ampulla of Vater.

Brunner's gland hyperplasia (BGH) is a diagnostic challenge where in the pathophysiology and natural history remain poorly understood. This Case Report describes BGH arising at the ampulla of Vater, causing abdominal pain and vomiting in a 46-year-old man. Owing to the inconclusive nature of imaging studies and suspicious intraoperative findings, a Whipple resection was performed without any complications. Histological analysis showed that the obstructing lesion was BGH, with no evidence of malignancy. This is only the second such case of its kind at the ampulla of Vater to be reported. In addition, we present the previously unreported endoscopic ultrasound findings. The subsequent literature review focuses on the pathophysiology, clinical presentation, diagnosis and management of BGH.

Brunner's gland adenoma: a report of two cases.

Brunner 's gland adenoma is a very rare benign tumor of the duodenum. Only two cases of the adenoma have been in the file of the surgical pathology unit of Ramathibodi Hospital since 1992 and presented in this communication. The tumor is capable of producing a variety of clinical manifestations. Presently, endoscopic study plays an important role in both detection and diagnostic biopsy. Local excision, either by endoscopy or surgery is the main treatment in symptomatic cases. Ductal malignancy on top of Brunner's gland adenoma was described in one from estimated 200 recorded cases in the English literature since 1835.

Tumor de las glándulas de Brunner / Brunner's gland tumor

Las glándulas de Brunner son estructuras túbulo-acinares ubicadas en la submucosa del duodeno. Secretan factores de crecimiento epidérmicos y un fluido alcalino que protege el epitelio duodenal de los jugos gástricos. Su crecimiento excesivo normalmente no da síntomas o éstos son mínimos, sin embargo, en ocasiones puede llegar a ser causa de hemorragia digestiva e incluso de obstrucción intestinal. El diagnóstico de esta patología es por lo general un hallazgo durante procedimientos endoscópicos , aunque la imagenología puede ser de gran ayuda. Pese a que no se han reportado casos de transformación maligna, la literatura describe que su tratamiento puede ser la observación en casos de lesiones pequeñas que no producen síntomas y en quienes la biopsia es categórica del diagnóstico. Dichas lesiones pueden ser tributarias de tratamiento endoscópico, reservando la cirugía clásica para tumores muy grandes, en casos de duda diagnóstica, cuando existen complicaciones o por fracaso de la técnica endoscópica. El resultado de las intervenciones es generalmente excelente sin existir hasta el momento estudios que señalen una recurrencia de las lesiones.

Hiperplasia nodular de las glandulas de Brunner: Presentacion de un caso y revision de la literatura / Bruner's gland hyperplasia: case report and literature review

Bruner's gland hyperplasia (BGH) is an infrequent benign injury located on the first or second portion of the duodenum. We presented the case of a 59 year-old man with vomits, diarrhea, upper gastrointestinal bleeding intermittent and loss of weight in which was a nodule in the duodenum that corresponded to an hyperplasia nodular of Brunner's gland.

Large Brunneroma presenting with bleeding.

Brunner's gland adenoma (Brunneroma) is a rare entity. We report a patient who presented with severe anemia due to bleed from a large Brunneroma arising from the duodenal bulb, and was managed successfully by surgical excision of the tumor.

Brunner's gland adenoma with circumferential duodenal involvement.

Brunner's gland adenoma is a benign tumor of the duodenum. We report a 58-year-old man who presented with abdominal pain, vomiting and weight loss. The patient underwent Whipple resection along with lymph node clearance. The resected tumor, 4 cm long, showed hypertrophied Brunner's glands.

Estenosis gastroduodenal por un adenoma de glándulas de Brünner: A propósito de una observación clínica y revisión de la literatura / Gastroduodenal stenosis caused by Brunner's glands adenoma

El adenoma o hiperplasia de las glándulas de Brünner es una rara lesión disembrioplásica o hiperplásica que se desarrolla habitualmente en la submucosa duodenal supravateriana. En más de la mitad de los casos es asintomático o presenta signos inespecíficos que llevan al estudio morfológico y endoscópicos, pero que pocas veces conducen al diagnóstico histológico. Complicaciones mayores como el sangrado y la obstrucción, sumado a la incertidumbre diagnóstica, suelen llevar a la exploración quirúrgica. El procedimento se adecuará al estado funcional gastroduodenal, volumen tumoral y estado general del paciente. Se presenta un caso de adenoma de glándula de Brünner de duodeno II-III que provocó un síndrome intermitente de estenosis gastroduodenal (SEGD), al que se le practicó una duodeno-pancreatectomía cefálica

Hiperplasia polipoide de las glandulas de brunner / Polypoid hyperplasia of Brunner's glands

Presentamos el caso de una mujer de 80 años con melena que presentó un pólipo en el duodeno que correspondió a una hiperplasia polipoide de las glándulas de Brunner.

Hypertrophie adenomateuse brunnerienne traitee par resection chirurgicale

Les auteurs rapportent l'observation d'une hyperplasie adenomateuse brunnerienne traitee par resection chirurgicale. Il s'agit d'une affection rare qui represente 10;6 pour cent des tumeurs benignines du duodenum. La symptomatologie clinique n'est pas univoque. Il n'existe pas de tableau typique pouvant permettre d'en faire le diagnostic. Les signes sont empruntes a la pathologie digestive; et son diagnostic est un diagnostic d'exclusion. Dans cette observation; la clinique etait dominee par la dyspepsie. L'endoscopie digestive haute et le transit baryte ont sensiblement ameliore les moyens diagnostiques de cette affection. Dans le cas rapporte ici; ces deux examens n'ont pas permis de poser le diagnostic ou de l'evoquer en pre-operatoire. L'examen antomo-pathologique apporte la preuve de la maladie. La chirurgie constitue le seul moyen therapeutique. C'est souvent la resection; mais; certains auteurs; en raison de l'absence de relation entre cette affection et la cancer; ont preconise des derivations internes

Adenoma gigante das glândulas de Brunner / Giant adenoma of Brunner's glands

Um paciente de 57 anos com sintomas de plenitude pós-prandial, eructaçöes e dor epigástrica em queimaçäo foi submetido a endoscopia digestiva alta, que revelou um pólipo de 8 cm no bulbo duodenal. O pólipo era pedunculado e prolapsava parcialmente para o piloro. Foi realizada polipectomia através de gastrostomia de 2 cm. No pós-operatório o paciente evoluiu bem, assintomático e sem complicaçöes. O exame anatomopatológico demonstrou a presença de um adenoma das glândulas de Brunner.