Olgu Sunumu
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Brunner Bezi Adenomu: Üst Gastrointestinal Kanama ile Seyreden Nadir Bir Olgu

Yıl 2025, Cilt: 2 Sayı: 3, 168 - 172, 28.10.2025
https://doi.org/10.70058/cjm.1761284

Öz

Özet

Giriş:
Brunner bezi adenomu, duodenumdaki Brunner bezlerinin aşırı proliferasyonundan kaynaklanan nadir, benign bir tümördür. Tüm duodenal tümörlerin yaklaşık %1’ini oluşturur ve genellikle asemptomatiktir. Ancak bazı vakalarda gastrointestinal kanama, obstrüksiyon veya dispeptik semptomlara neden olabilir.

Olgu Sunumu:
Bu çalışmada, halsizlik, bulantı, kusma ve melena şikâyetleri ile acil servise başvuran 58 yaşında kadın hasta sunulmaktadır. Hastanın koroner arter hastalığı öyküsü vardı ve günlük asetilsalisilik asit tedavisi almaktaydı. Üst gastrointestinal endoskopide, duodenum bulbusta, yüzeyi düzensiz ve pıhtılı, kısmi lümen tıkanıklığına yol açan, 1,8 × 1,6 × 1 cm boyutlarında saplı bir polip saptandı. Endoskopik polipektomi başarıyla gerçekleştirildi ve histopatolojik inceleme Brunner bezi adenomu tanısını doğruladı. Malignite veya displazi saptanmadı.

Tartışma:
Brunner bezi adenomları, endoskopik değerlendirme sırasında saptanan duodenal poliplerin ayırıcı tanısında dikkate alınmalıdır. Tipik olarak benign olmalarına rağmen, bu lezyonlar ciddi klinik semptomlara yol açabilir ve maligniteyi taklit edebilir. Küçük ve saplı lezyonlarda endoskopik polipektomi tercih edilen tedavi yöntemidir; daha büyük veya geniş tabanlı lezyonlarda cerrahi eksizyon gerekebilir. Rekürrens veya komplikasyonların izlenmesi için dikkatli takip önemlidir.

Kaynakça

  • Patel ND, Levy AD, Mehrotra AK, Sobin LH. Brunner’s gland hyperplasia and hamartoma: Imaging features with clinicopathologic correlation. AJR Am J Roentgenol. 2006; 187:715–22.
  • Zhu M, Li H, Wu Y, An Y, Wang Y, Ye C, et al. Brunner’s gland hamartoma of the duodenum: A literature review. Adv Ther. 2021; 38:2779–94.
  • Rana R, Sapkota R, Kc B, Hirachan A, Limbu B. Giant Brunner’s gland adenoma presenting as upper gastrointestinal bleeding in a 76-year-old male: A case report. JNMA J Nepal Med Assoc. 2019; 57:50–3.
  • Chatziisaak D, Piachas A, Burri P, Wolf S, Steffen T. Giant Duodenal Brunneroma: Report of a Rare Case and Review of the Literature. Am J Case Rep. 2024 Dec 18;25: e945913. doi: 10.12659/AJCR.945913.
  • Naito S, Fukuzawa M, Nakamura S, Kono S, Matsubayashi J, Itoi T. Giant Brunner’s gland hamartoma diagnosed via endoscopic mucosal resection: A case report. DEN Open. 2021; (1):e65. doi: 10.1002/deo2.65. PMID: 35310720; PMCID:PMC8828167.
  • Valantine B, Venkatapur M, Nawahirsha S, Kumar SB. Giant Brunner gland hamartoma: An unusual cause of upper gastrointestinal bleed. Gastroenterology, Hepatology and Endoscopy Practice. 2023;3(3):90-93. doi: 10.4103/ghep.ghep_9_23.
  • Mendes I, Vara-Luiz F, Nunes G, Cruz J, Antunes SC, Fonseca J. A giant Brunner’s gland hamartoma: A rare cause of upper gastrointestinal bleeding. Acta Gastroenterol Belg. 2024 Apr- Jun;87(2):340. doi: 10.51821/87.2.12806. PMID: 39210769.
  • Peetz ME, Moseley HS. Brunner’s gland hyperplasia. Am Surg. 1989 Jul;55(7):474-7. PMID: 2662841.
  • Kurella RR, Ancha HR, Hussain S, Lightfoot SA, Harty R. Evolution of Brunner gland hamartoma associated with Helicobacter pylori infection. South Med J. 2008; 101:648–650. doi: 10.1097/SMJ.0b013e318172435a.
  • Kovaceviæ I, Ljubiciæ N, Cupiæ H, et al. Helicobacter pylori infection in patients with Brunner’s gland adenoma. Acta Med Croatica. 2001; 55:157–160.
  • Alsugair Z, Lavrut PM, Chassagne L. A 10 cm pedunculated duodenal Brunner gland hamartoma: Case report and literature review. Int J Surg Case Rep. 2022; 100:107747. doi: 10.1016/j.ijscr.2022.107747. PMID: 36270207; PMCID: PMC9587310.
  • Dhali A, Ray S, Mandal TS, et al. Surgical outcome of Brunner’s gland hamartoma: A single-centre experience. Surg J (N Y). 2022;8(1):e14-e18. doi: 10.1055/s-0041-1741510. PMID: 35059497; PMCID: PMC8763466.
  • Mendes I, Vara-Luiz F, Nunes G, Cruz J, Antunes SC, Fonseca J. A giant Brunner’s gland hamartoma: A rare cause of upper gastrointestinal bleeding. Acta Gastroenterol Belg. 2024; 87(2):340. doi: 10.51821/87.2.12806. PMID: 39210769.172 https://dergipark.org.tr/en/pub/cjm
  • Lee W, Yang H, Lee Y, et al. Brunner’s gland hyperplasia: Treatment of severe diffuse nodular hyperplasia mimicking a malignancy in the pancreaticoduodenal area. J Korean Med Sci.2008; 23:540-3.
  • Iusco D, Roncoroni L, Violi V, Donadei E, Sarli L. Brunner’s gland hamartoma: ‘Overtreatment’ of a voluminous mass simulating a malignancy of the pancreaticoduodenal area. JOP. 2005; 6:348-53.
  • Stewart ZA, Hruban RH, Fishman EF, Wolfgang CL. Surgical management of giant Brunner’s gland hamartoma: Case report and literature review. World J Surg Oncol. 2009;7:68. doi: 10.1186/1477-7819-7-68. PMID: 19725968.
  • Reddy RR, Schuman BM, Priest RJ. Duodenal polyps: Diagnosis and management. J Clin Gastroenterol. 1981; 3:139-147.
  • Levine JA, Burgart LJ, Batts KP, Wang KK. Brunner’s gland hamartomas: Clinical presentation and pathological features of 27 cases. Am J Gastroenterol. 1995; 90:290–4.
  • Joseph MN, Laird DJ, Petrosyan M, Selby R, Kulkarni S (2021) Brunner’s Gland Hamartoma: A Case Report, Meta-Analysis, and Algorithm Approach to Obstructing Duodenal Masses. Archiv Surg S Educ 3: 031. doi: 10.24966/ASSE-3126/100031.
  • Naito S, Fukuzawa M, Nakamura S, Kono S, Matsubayashi J, Itoi T. Giant Brunner’s gland hamartoma diagnosed via endoscopic mucosal resection: A case report. DEN Open. 2021 ;2(1): e65. doi: 10.1002/deo2.65. PMID: 35310720.
  • Maruo M, Tahara T, Inoue F, et al. A giant Brunner gland hamartoma successfully treated by endoscopic excision followed by transanal retrieval: A case report. Medicine 2021;100(14): e25048. doi: 10.1097/MD.0000000000025048.

Brunner Gland Adenoma: A Rare Case Presenting with Upper Gastrointestinal Bleeding

Yıl 2025, Cilt: 2 Sayı: 3, 168 - 172, 28.10.2025
https://doi.org/10.70058/cjm.1761284

Öz

Introduction
Brunner gland adenoma is a rare benign tumor originating from the excessive proliferation of Brunner glands in the duodenum. It accounts for approximately 1% of all duodenal tumors and is often asymptomatic. However, in some cases, it may cause gastrointestinal bleeding, obstruction, or dyspeptic symptoms.
Case Presentation:
We present the case of a 58-year-old female who was admitted to the emergency department with fatigue, nausea, vomiting, and melena. She had a history of coronary artery disease and was on daily acetylsalicylic acid therapy. Upper gastrointestinal endoscopy revealed a pedunculated polyp measuring 1.8 × 1.6 × 1 cm in the duodenal bulb, with an irregular clotted surface causing partial luminal obstruction. Endoscopic polypectomy was successfully performed, and histopathological examination confirmed the diagnosis of Brunner gland adenoma. No malignancy or dysplasia was detected.
Discussion:
Brunner gland adenomas should be considered in the differential diagnosis of duodenal polyps detected during endoscopic evaluation. Although typically benign, these lesions can lead to significant clinical symptoms and may mimic malignancy. Endoscopic polypectomy is the preferred treatment for small and pedunculated lesions, while surgical excision may be required for larger or broad-based lesions. Careful follow-up is essential to monitor for recurrence or complications.

Etik Beyan

yok

Destekleyen Kurum

yok

Teşekkür

yok

Kaynakça

  • Patel ND, Levy AD, Mehrotra AK, Sobin LH. Brunner’s gland hyperplasia and hamartoma: Imaging features with clinicopathologic correlation. AJR Am J Roentgenol. 2006; 187:715–22.
  • Zhu M, Li H, Wu Y, An Y, Wang Y, Ye C, et al. Brunner’s gland hamartoma of the duodenum: A literature review. Adv Ther. 2021; 38:2779–94.
  • Rana R, Sapkota R, Kc B, Hirachan A, Limbu B. Giant Brunner’s gland adenoma presenting as upper gastrointestinal bleeding in a 76-year-old male: A case report. JNMA J Nepal Med Assoc. 2019; 57:50–3.
  • Chatziisaak D, Piachas A, Burri P, Wolf S, Steffen T. Giant Duodenal Brunneroma: Report of a Rare Case and Review of the Literature. Am J Case Rep. 2024 Dec 18;25: e945913. doi: 10.12659/AJCR.945913.
  • Naito S, Fukuzawa M, Nakamura S, Kono S, Matsubayashi J, Itoi T. Giant Brunner’s gland hamartoma diagnosed via endoscopic mucosal resection: A case report. DEN Open. 2021; (1):e65. doi: 10.1002/deo2.65. PMID: 35310720; PMCID:PMC8828167.
  • Valantine B, Venkatapur M, Nawahirsha S, Kumar SB. Giant Brunner gland hamartoma: An unusual cause of upper gastrointestinal bleed. Gastroenterology, Hepatology and Endoscopy Practice. 2023;3(3):90-93. doi: 10.4103/ghep.ghep_9_23.
  • Mendes I, Vara-Luiz F, Nunes G, Cruz J, Antunes SC, Fonseca J. A giant Brunner’s gland hamartoma: A rare cause of upper gastrointestinal bleeding. Acta Gastroenterol Belg. 2024 Apr- Jun;87(2):340. doi: 10.51821/87.2.12806. PMID: 39210769.
  • Peetz ME, Moseley HS. Brunner’s gland hyperplasia. Am Surg. 1989 Jul;55(7):474-7. PMID: 2662841.
  • Kurella RR, Ancha HR, Hussain S, Lightfoot SA, Harty R. Evolution of Brunner gland hamartoma associated with Helicobacter pylori infection. South Med J. 2008; 101:648–650. doi: 10.1097/SMJ.0b013e318172435a.
  • Kovaceviæ I, Ljubiciæ N, Cupiæ H, et al. Helicobacter pylori infection in patients with Brunner’s gland adenoma. Acta Med Croatica. 2001; 55:157–160.
  • Alsugair Z, Lavrut PM, Chassagne L. A 10 cm pedunculated duodenal Brunner gland hamartoma: Case report and literature review. Int J Surg Case Rep. 2022; 100:107747. doi: 10.1016/j.ijscr.2022.107747. PMID: 36270207; PMCID: PMC9587310.
  • Dhali A, Ray S, Mandal TS, et al. Surgical outcome of Brunner’s gland hamartoma: A single-centre experience. Surg J (N Y). 2022;8(1):e14-e18. doi: 10.1055/s-0041-1741510. PMID: 35059497; PMCID: PMC8763466.
  • Mendes I, Vara-Luiz F, Nunes G, Cruz J, Antunes SC, Fonseca J. A giant Brunner’s gland hamartoma: A rare cause of upper gastrointestinal bleeding. Acta Gastroenterol Belg. 2024; 87(2):340. doi: 10.51821/87.2.12806. PMID: 39210769.172 https://dergipark.org.tr/en/pub/cjm
  • Lee W, Yang H, Lee Y, et al. Brunner’s gland hyperplasia: Treatment of severe diffuse nodular hyperplasia mimicking a malignancy in the pancreaticoduodenal area. J Korean Med Sci.2008; 23:540-3.
  • Iusco D, Roncoroni L, Violi V, Donadei E, Sarli L. Brunner’s gland hamartoma: ‘Overtreatment’ of a voluminous mass simulating a malignancy of the pancreaticoduodenal area. JOP. 2005; 6:348-53.
  • Stewart ZA, Hruban RH, Fishman EF, Wolfgang CL. Surgical management of giant Brunner’s gland hamartoma: Case report and literature review. World J Surg Oncol. 2009;7:68. doi: 10.1186/1477-7819-7-68. PMID: 19725968.
  • Reddy RR, Schuman BM, Priest RJ. Duodenal polyps: Diagnosis and management. J Clin Gastroenterol. 1981; 3:139-147.
  • Levine JA, Burgart LJ, Batts KP, Wang KK. Brunner’s gland hamartomas: Clinical presentation and pathological features of 27 cases. Am J Gastroenterol. 1995; 90:290–4.
  • Joseph MN, Laird DJ, Petrosyan M, Selby R, Kulkarni S (2021) Brunner’s Gland Hamartoma: A Case Report, Meta-Analysis, and Algorithm Approach to Obstructing Duodenal Masses. Archiv Surg S Educ 3: 031. doi: 10.24966/ASSE-3126/100031.
  • Naito S, Fukuzawa M, Nakamura S, Kono S, Matsubayashi J, Itoi T. Giant Brunner’s gland hamartoma diagnosed via endoscopic mucosal resection: A case report. DEN Open. 2021 ;2(1): e65. doi: 10.1002/deo2.65. PMID: 35310720.
  • Maruo M, Tahara T, Inoue F, et al. A giant Brunner gland hamartoma successfully treated by endoscopic excision followed by transanal retrieval: A case report. Medicine 2021;100(14): e25048. doi: 10.1097/MD.0000000000025048.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Gastroenteroloji ve Hepatoloji, Patoloji
Bölüm Case Reports
Yazarlar

İlkay Çinar 0000-0002-2632-3209

Gökhan Aydın 0000-0002-2245-5941

Yayımlanma Tarihi 28 Ekim 2025
Gönderilme Tarihi 11 Ağustos 2025
Kabul Tarihi 15 Eylül 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 2 Sayı: 3

Kaynak Göster

Vancouver Çinar İ, Aydın G. Brunner Gland Adenoma: A Rare Case Presenting with Upper Gastrointestinal Bleeding. Cerasus J Med. 2025;2(3):168-72.