de la Riva Susana, Carrascosa Juan, Muñoz-Navas Miguel, Súbtil José Carlos, Carretero Cristina, Sola Jesús Javier, Hernández-Lizoain José Luis
Servicio de Cirugía General, Clínica Universidad de Navarra, Navarra, España.
Gastroenterol Hepatol. 2011 May;34(5):333-6. doi: 10.1016/j.gastrohep.2011.02.001. Epub 2011 Apr 8.
Brunner's gland hamartoma is a polypoid lesion typically composed of an increased quantity of normal-appearing Brunner's glands, accompanied by a variable proportion of smooth muscle. Most of these masses are asymptomatic and behave as benign tumors. Occasionally tumoral growth can provoke gastrointestinal problems which, together with the possibility of malignant transformation, will require resection after a broad differential diagnosis has been made with solitary duodenal mass. Both clinical and radiographic studies are nonspecific and often do not allow diagnosis of these tumors. Basic endoscopic studies (upper endoscopy) with adequate characterization of the lesion by endoscopic ultrasound (EUS) can establish a high diagnostic suspicion and determine the best therapeutic option (endoscopy or surgery). We present a case of giant Brunner's gland hamartoma. The initial manifestation was iron-deficiency anemia with no evidence of bleeding. After adequate characterization of the lesion, EUS allowed complete and safe endoscopic resection, avoiding more invasive surgical treatment.
布伦纳腺错构瘤是一种息肉样病变,通常由数量增多的外观正常的布伦纳腺组成,并伴有不同比例的平滑肌。这些肿块大多无症状,表现为良性肿瘤。偶尔肿瘤生长会引发胃肠道问题,连同恶变的可能性,在与孤立性十二指肠肿块进行广泛鉴别诊断后需要进行切除。临床和影像学研究均无特异性,通常无法诊断这些肿瘤。通过内镜超声(EUS)对病变进行充分特征化的基础内镜检查(上消化道内镜检查)可建立高度的诊断怀疑并确定最佳治疗方案(内镜检查或手术)。我们报告一例巨大布伦纳腺错构瘤病例。最初表现为缺铁性贫血,无出血证据。在对病变进行充分特征化后,EUS实现了完整且安全的内镜切除,避免了更具侵入性的手术治疗。