2025 Volume 67 Issue 2 Pages 140-148
Here, we present a case of giant Brunnerʼs gland hyperplasia. Although it is often discovered as a submucosal lesion in the duodenum, a definitive diagnosis is challenging. Moreover, if the lesion is large or tends to increase in size, it may be difficult to distinguish it from a malignant neoplasm or it may result in an impaired passage or a complicated obstruction. A74-year-old woman had a 60-mm-sized submucosal tumor in the duodenal bulb, which was suspected to be Brunnerʼs gland hyperplasia. However, the patient did not wish to undergo treatment at that time, which led to the decision of just observing the patient. Regular follow-ups were performed; however, the lesion did not increase in size or cause any subjective symptoms. Eleven years later, the patient presented with epigastric pain. Contrast-enhanced CT and emergency esophagogastroduodenoscopy revealed the same lesion in the duodenal descending part. The lesion was resected via endoscopic submucosal dissection in the presence of a gastroenterology surgeon. Pathological examination revealed a 75×32×26 mm Brunnerʼs gland hyperplasia lesion. Since giant Brunnerʼs gland hyperplasia may cause obstruction or incarceration in the future, early prophylactic resection could be considered as a treatment option.
