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Case Reports
. 2025 Jul 22;17(7):e88551.
doi: 10.7759/cureus.88551. eCollection 2025 Jul.

Adenomatous Hyperplasia of Duodenal Brunner's Glands: An Extremely Uncommon Imitation of Malignant Pathology

Archit Garg  1 , Vikram Jeet Singh Gill  1 , Mehak Bassi  2 , Andrew Korman  2 , Arkady Broder  3
Affiliations
Case Reports

Adenomatous Hyperplasia of Duodenal Brunner's Glands: An Extremely Uncommon Imitation of Malignant Pathology

Archit Garg et al. Cureus. .

Abstract

Adenomatous hyperplasia of duodenal Brunner's glands is a rare benign pathology of the duodenum linked to epigastric pain and dyspepsia. However, in rare cases, it can cause intestinal obstruction. Hence, endoscopic or surgical removal of Brunner's gland hyperplasia (BGH) has been suggested to prevent complications including hemorrhage, severe anemia due to persistent bleeding, intussusception, and obstruction. BGH can be managed with endoscopic polypectomy. It represents a less invasive alternative to surgery and is more cost-effective. The medical treatment mainly involves treating gastric hyperacidity, a known cause of BGH, but the regression of BGH is rare. This case report aims to describe and investigate the clinicopathologic features of this rare pathology. The case emphasizes the importance of endoscopy for the evaluation of the refractory gastroesophageal reflux-like presentation and demonstrates that histopathological evaluation remains critical for a definitive diagnosis of BGH and to rule out malignancy. Conservative approaches may suffice in select patients, avoiding invasive interventions. Follow-up remains essential to monitor for recurrence or complications.

Keywords: adenomyoma; brunner's gland hyperplasia; duodenal nodule; esophagogastroduodenoscopy; heartburn.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. EGD showing a nodule in the second portion of the duodenum
EGD: Esophagogastroduodenoscopy
Figure 2
Figure 2. Biopsy of the nodule showing duodenal mucosa with submucosal nodules composed of benign glands and smooth muscle bundles, consistent with adenomatous hyperplasia
Figure 3
Figure 3. Histology of the nodule showing nodular disorganization with the proliferation of ducts, glands, and smooth muscle cells
Figure 4
Figure 4. Magnified histologic image showing nodular disorganization
See this image and copyright information in PMC

References

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