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Case Reports
. 2017:2017:6940649.
doi: 10.1155/2017/6940649. Epub 2017 Feb 19.

A Giant Brunneroma Causing Gastrointestinal Bleeding and Severe Anemia Requiring Transfusion and Surgery

Nicola C Frenkel  1 , Miangela M Laclé  2 , Inne H M Borel Rinkes  1 , Izaak Q Molenaar  1 , Jeroen Hagendoorn  1
Affiliations
Case Reports

A Giant Brunneroma Causing Gastrointestinal Bleeding and Severe Anemia Requiring Transfusion and Surgery

Nicola C Frenkel et al. Case Rep Surg. 2017.

Abstract

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 conclusive. As we were unable to determine the nature of the mass preoperatively and due to the severe symptoms, its size, and the uncertain malignant potential, a classic Whipple procedure was performed. The resected specimen showed extensive proliferation of Brunner's glands without signs of malignancy.

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Conflict of interest statement

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Figures

Figure 1
Figure 1
Axial CT view showing a large mass of approximately 8 cm in diameter, near the proximal duodenum. Oral and IV contrast were given.
Figure 2
Figure 2
Coronal CT view showing a large mass near the proximal duodenum. Oral and IV contrast were given.
Figure 3
Figure 3
Histopathological examination. (a) 8 × 4 × 8 cm submucosal polypoid tumor in the proximal duodenum. ((b) and (c)) Microscopic examination showed extensive proliferation of Brunner's glands.
See this image and copyright information in PMC

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