Endoscopic resection of a large pedunculated Brunner's gland hyperplasia

Abstract

A 70-year-old asymptomatic man presented with a growing submucosal tumor in the duodenal bulb; and despite two EUS-FNA procedures, a diagnosis could not be confirmed. Since the mass was stalked and enlarged to 40 mm in size, the patient underwent endoscopic resection with grasping scissor forceps, while traction was applied for diagnostic treatment, considering the risk of gastrointestinal obstruction. The pathological diagnosis was Brunner's gland hyperplasia, and the patient was followed up with annual upper gastrointestinal endoscopy. Here, we report a case of endoscopic resection of a large duodenal submucosal tumor using a traction device.