Giant Brunner's gland hyperplasia of the duodenum successfully resected en bloc by endoscopic mucosal resection: A case report.

Autor:	Makazu M; Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura 247-8533, Japan. m_makazu@shonankamakura.or.jp., Sasaki A; Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura 247-8533, Japan., Ichita C; Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura 247-8533, Japan., Sumida C; Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa 247-8533, Japan., Nishino T; Department of Gastroenterology, Shonan Kamakura General Hospital, Kanagawa 247-8533, Japan., Nagayama M; Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Kamakura 247-8533, Japan., Teshima S; Department of Pathology, Shonan Kamakura General Hospital, Kamakura 247-8533, Japan.
Jazyk:	angličtina
Zdroj:	World journal of gastrointestinal endoscopy [World J Gastrointest Endosc] 2024 Jun 16; Vol. 16 (6), pp. 368-375.
DOI:	10.4253/wjge.v16.i6.368
Abstrakt:	Background: Duodenal Brunner's gland hyperplasia (BGH) is a therapeutic target when complications such as bleeding or gastrointestinal obstruction occur or when malignancy cannot be ruled out. Herein, we present a case of large BGH treated with endoscopic mucosal resection (EMR). Case Summary: An 83-year-old woman presented at our hospital with dizziness. Blood tests revealed severe anemia, esophagogastroduodenoscopy showed a 6.5 cm lesion protruding from the anterior wall of the duodenal bulb, and biopsy revealed the presence of glandular epithelium. Endoscopic ultrasonography (EUS) demonstrated relatively high echogenicity with a cystic component. The muscularis propria was slightly elevated at the base of the lesion. EMR was performed without complications. The formalin-fixed lesion size was 6 cm × 3.5 cm × 3 cm, showing nodular proliferation of non-dysplastic Brunner's glands compartmentalized by fibrous septa, confirming the diagnosis of BGH. Reports of EMR or hot snare polypectomy are rare for duodenal BGH > 6 cm. In this case, the choice of EMR was made by obtaining information on the base of the lesion as well as on the internal characteristics through EUS. Conclusion: Large duodenal lesions with good endoscopic maneuverability and no evident muscular layer involvement on EUS may be resectable via EMR. Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article. (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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