Endosonographic appearances of Brunner's gland hamartomas

Abstract

Brunner's gland hamartoma is an uncommon intestinal tumor, most frequently located in the duodenal bulb. We report the endoscopic sonographic (EUS) appearances in 2 cases of Brunner's gland hamartoma. In 1 case, EUS revealed a heterogeneous hypoechoic pedunculated mass, 1.7 cm in diameter, arising from the mucosal and submucosal layers of the wall of the duodenal bulb. Multiple anechoic large and small cystic areas were demonstrated in the tumor. In the other case, EUS revealed a 1.4- x 0.9-cm pedunculated mass with an echogenicity higher than that of the muscular layer and lower than that of the mucosa, arising from the submucosal layer of the duodenal bulb wall. Multiple small anechoic areas were demonstrated in the tumor. We believe that both EUS patterns are typical for Brunner's gland hamartomas.

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

“…EUS is an excellent imaging modality to assess GI sub-epithelial lesions. Only a few cases have reported the endosonographic appearances of BGHs (Table 1) [6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18]. The lesions arise from deep mucosa or submucosa and do not breach the muscularis propria layer.…”

Brunner’s Gland Hyperplasia: A Rare Cause for Gastric Outlet Obstruction

“…There may be non-specific symptoms like dyspepsia, vague epigastric discomfort, or occult blood in stool. The high vascularity of BGH may predispose to bleeding in these lesions which may be frank or microscopic [13,14]. It has been observed that obstructive symptoms are more commonly seen in Brunner's gland hamartomas than hyperplasia.…”

Cystic Brunner’s gland hamartoma in the duodenum: A case report

“…The latter cases revealed smooth muscle proliferation and small cystic dilatation of the Brunner's glands. Up to now, to our knowledge, no study has described predominant cystic lesions of Brunner's gland hamartoma found on imaging modalities such as MDCT and MRI, except for two cases that were found on endoscopic ultrasonography [5,6] . Endoscopic ultrasonography provides additional information about the internal components of the duodenal mass.…”

“…There has been no literature depicting predominant cystic lesions of Brunner's gland hamartoma in imaging modalities, except for two cases that were found at endoscopic ultrasonography. Although mild dilatation of the ducts may be present in Brunner's gland lesions, it is only detected in histologic test [5,6] . Herein, we introduce a rare cystic Brunner's gland hamartoma with a long stalk arising from the duodenal third portion found on multidetector-row computed tomography (MDCT), magnetic resonance imaging (MRI), and a modified small bowel series, together with pathologic correlation.…”