[Large Brunner adenoma in the duodenal bulb--a case report]

Benign, proliferative changes of the Brunner's gland are very rare and account for about 10% of duodenal bulb neoplasias. The authors present a case of Brunner's gland adenoma of unusual dimensions (12 x 5 x 2.5 cm). The patient presented with vague epigastric discomfort as isolated symptoms. In this case we performed surgical treatment, including a duodenotomy and polypectomy. Because they are localized in the submucosa small, superficial endoscopic biopsies may fail to confirm the diagnosis. Malignancy seems to occur only very rarely, with only 14 cases reported in the literature. As the majority of Brunner's adenomas are quite small, endoscopic polypectomy will confirm the diagnosis and cure the condition in most cases. Large symptomatic adenomas may require surgical resection.