Clinical Characteristics of Large Brunner's Gland Tumors in Korea

Kang, Ji Hun; Lim, Yun Jeong; Hahn, Suk Jae; Choi, Jong Sun; Koh, Moon Soo; Lee, Jin Ho

Abstract

BACKGROUND/AIMS
Brunner's gland tumor is a common benign tumor noted in duodenum and might be designated as Brunner's gland hamartoma, adenoma or hyperplasia. But, a large duodenal polyp (over 1 cm in diameter) pathologically proven as a tumor of Brunner's gland origin is rare.
METHODS
We analyzed a total of 39 cases including our direct experience of two cases and reports of 37 cases to clarify the clinical features of large Brunner's gland tumors.
RESULTS
This tumor tends to present predominantly after the fourth decade: Median age is 52.6 years. Neither gender showed predominance. The size of the tumor ranged from 1 to 8 cm and the mean diameter was 2.9 cm. The most common location was the bulb. A pedunculated polyp was the common appearance. Epigastric pain was the most common symptom. Brunner's gland tumor can cause gastrointestinal hemorrhage or obstruction. Most of the polyps had non-diagnostic pathologic yield at pinch biopsy and only one case was diagnosed as focal adenocarcinoma. Endoscopic or surgical removal was undertaken for treatment. Most cases had no recurrence after removal. Snare polypectomy or submucosal dissection very safe and useful treatment modalities.
CONCLUSIONS
Large Brunner's gland tumors are mostly found during a check up or epigastric pain. Anemia, melena and obstruction often develop. Endoscopic polypectomy is recommended as a first line treatment.