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Case Reports
. 2013 Jul 18;7(2):304-7.
doi: 10.1159/000354138. Print 2013 May.

Successful Endoscopic Resection of Large Pedunculated Brunner's Gland Hamartoma Causing Gastrointestinal Bleeding Arising from the Pylorus

Yunho Jung  1 , Il Kwun Chung, Tae Hoon Lee, Young Sin Cho, Yeong Geol Jo, Sang Heum Park, Hyundeuk Cho, Sun Joo Kim
Affiliations
Case Reports

Successful Endoscopic Resection of Large Pedunculated Brunner's Gland Hamartoma Causing Gastrointestinal Bleeding Arising from the Pylorus

Yunho Jung et al. Case Rep Gastroenterol. .

Abstract

Brunner's gland hamartoma is a rare benign small bowel neoplasm and most lesions are small and asymptomatic. However, large hamartoma-related obstructive symptoms and hemorrhage related to tumor ulceration manifest as hematemesis or melena. The exact pathogenesis if these lesions is not well known, but they are thought to be frequently associated with Helicobacter pylori infections and chronic pancreatitis. We report the case of a 45-year-old man who presented with melena due to a large pedunculated Brunner's gland hamartoma arising from the pylorus. It was successfully removed by endoscopic mucosal resection with piecemeal technique because of too large tumor size for application of a conventional snare.

Keywords: Brunner's gland hamartoma; Endoscopic mucosal resection; Hematemesis; Melena.

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Figures

Fig. 1
Fig. 1
Esophagogastroduodenoscopy showed a large pedunculated mass arising from the pyloric ring.
Fig. 2
Fig. 2
A mass about 5 cm in size was pinned on flat cork plates immediately following resection.
Fig. 3
Fig. 3
Hyperplastic lobules of proliferated Brunner's glands separated by fibrous septa (H&E, ×40).
See this image and copyright information in PMC

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