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Case Reports
. 2007 Oct 12;1(1):103-9.
doi: 10.1159/000108944.

Carcinoma Arising from Brunner's Gland in the Duodenum after 17 Years of Observation - A Case Report and Literature Review

Masaru Koizumi  1 , Naohiro Sata, Koji Yoshizawa, Katsumi Kurihara, Yoshikazu Yasuda
Affiliations
Case Reports

Carcinoma Arising from Brunner's Gland in the Duodenum after 17 Years of Observation - A Case Report and Literature Review

Masaru Koizumi et al. Case Rep Gastroenterol. .

Abstract

A 60-year-old man presented with melena and hematemesis in 1984. Esophagogastroduodenoscopy (EGD) detected a small protruding lesion in the duodenal bulb, which was diagnosed as Brunner's adenoma. No significant change was detected in subsequent annual EGD and biopsies for 10 years, after which the patient was not observed for 7 years. The patient presented with melena again in 2001. The lesion had changed shape to become a 10 mm sessile tumor with a central depression, and following a biopsy was diagnosed as an adenocarcinoma. The patient underwent partial resection of the duodenum. Histopathological assessment showed acidophilic cells with swollen nuclei, and clear cells forming a tubular or papillary tubule in the mucosal lamina propria and submucosal layer. The tumor cells stained positive for lysozyme, indicating that they arose from Brunner's gland. The patient showed no sign of recurrence and was disease-free for more than 34 months after surgery. The patient died of pneumonia. This is an extremely rare case of primary duodenal carcinoma arising from Brunner's gland in a patient observed for 17 years.

Keywords: Adenocarcinoma; Brunner's gland; Duodenal cancer.

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Figures

Fig. 1
Fig. 1
Esophagogastroduodenoscopy showing a 10 mm sessile tumor with a central depression in the duodenal bulb.
Fig. 2
Fig. 2
Hypotonic duodenography showing a contrast media-positive elevated lesion in the center of the duodenal bulb.
Fig. 3
Fig. 3
Microscopic findings of the tumor. a Gross appearance following hematoxylin and eosin staining (×2). b Adenocarcinoma in an adenoma (hematoxylin and eosin stain, ×10). c MIB-1-positive neoplastic cells (×10). d Lysozyme-positive neoplastic cells (×10).
See this image and copyright information in PMC

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