Endosonographic Appearances of a Rare Duodenal Tumour, Brunner’s Gland Hamartoma

Abstract

Brunner’s gland hamartoma (BGH) is a rare sub-epithelial tumour of the duodenum, which may cause haemorrhagic or obstructive gastrointestinal symptoms. Their accurate histological diagnosis often remains elusive before resection. Although endoscopic ultrasonography (EUS) is considered an excellent modality to study lesions within the gastrointestinal wall, only a few reports have described endosonographic characteristics of BGHs. A reliable pre-resection diagnosis with EUS may not only allay fear of malignancy but may as well avert a major surgery for the patients. In this report, we present a rare case of a large BGH in a young female who presented with acute gastrointestinal bleeding. Here, the endosonographic features assuaged the concern for malignancy while aiding in complete and uneventful surgical resection of the tumour via a submucosal plane.

Endoscopic Ultrasonography-Guided Fine-Needle Aspiration for Duodenal Subepithelial Lesions Showing a Hypoechoic Mass on Endoscopic Ultrasound Imaging

“…Large DSELs and those associated with symptoms (e.g., bleeding and passage obstruction) are candidates for resection. 3 , 14 By contrast, asymptomatic submucosal tumors ≤20 mm in diameter are treated on a case-by-case basis. 5 , 14 In most cases, surgical resection is the treatment of choice when malignancy is suspected, but there are reports of less invasive endoscopic resection (ER) when the tumor size is small.…”