Dhouha B, Ahlem L, Sana B S, Saadia B, Sabeh M R
Department of Pathology, Mongi Slim Hospital, Daoued, Tunisia.
Pathologica. 2017 Dec;109(4):414-417.
Brunner's gland hyperplasia is a rare benign lesion arising from the duodenum. It is often an incidental finding on endoscopy with the majority of patients being asymptomatic. It may also present with various symptoms depending on location and tumor size, such as gastrointestinal bleeding, obstruction and abdominal pain. We report an unusual case of large Brunner's gland hyperplasia in 72-years old man, admitted to hospital for epigastric pain, recurrent vomiting and significantly weight loss. Upper endoscopy showed an obstructive submucosis tumour of the bulb. Abdominal computed tomography scan revealed a circumferential thickening and stenosing mass of the first part of the duodenum leading to severe obstruction. Though pre-operative biopsies were negative, imaging studies and endoscopy were strongly suggestive of malignancy and the patient underwent duodenocephalopancreatectomy. Brunner's gland hyperplasia may have unusual presentation, mimicking malignancy. Therefore, extensive pre-operative evaluation, including repetitive tumor biopsies, is necessary to avoid radical surgical procedure.
布伦纳腺增生是一种起源于十二指肠的罕见良性病变。它常在内镜检查时偶然发现，大多数患者无症状。根据病变位置和肿瘤大小，也可能出现各种症状，如胃肠道出血、梗阻和腹痛。我们报告一例72岁男性的巨大布伦纳腺增生罕见病例，该患者因上腹部疼痛、反复呕吐和显著体重减轻入院。上消化道内镜检查显示十二指肠球部有一个阻塞性黏膜下肿瘤。腹部计算机断层扫描显示十二指肠第一部有环形增厚和狭窄肿块，导致严重梗阻。尽管术前活检为阴性，但影像学检查和内镜检查强烈提示为恶性肿瘤，患者接受了十二指肠胰头切除术。布伦纳腺增生可能有不寻常的表现，类似恶性肿瘤。因此，需要进行广泛的术前评估，包括重复肿瘤活检，以避免进行根治性手术。
