Endoscopic resection of multiple duodenal Brunner gland tumors

We report a rare case of multiple concurrent Brunner’s gland hamartomas diagnosed and treated via endoscopic resection.

A 46-year-old female presented with multiple submucosal duodenal tumors, identified during an upper gastrointestinal endoscopy. Her medical history was unremarkable, but she had experienced several months of epigastric discomfort and dyspepsia. Hematological tests were normal.

Endoscopy revealed six submucosal mass lesions in the second duodenum, the largest measuring approximately 2 cm. The lesions were covered by normal mucosa, and a small hole was observed on top of one lesion with a “soft cushion sign”. Endoscopic ultrasound (EUS) showed a homogeneous hypoechoic lesion with a septate wall in the submucosal layer, consistent with a cystic proliferative submucosal tumor.

Due to their size and number, the three largest lesions were removed by endoscopic mucosal resection for definitive diagnosis. Histological examination confirmed all three lesions as Brunner’s gland hamartomas. The patient was advised to remove the remaining lesions but declined and was discharged.

One year later, the patient underwent endoscopic resection of the remaining lesion, which was also histologically confirmed as a Brunner’s gland hamartoma. The patient was discharged, and no recurrence was observed during several years of follow-up.

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
27 March 2025