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Recurrent giant Brunner's gland adenoma.
Il Giornale Di Chirurgia
|May 28, 2019
Summary
Benign duodenal tumors, particularly Brunner's gland adenomas, are rare. A patient experienced a recurrence after endoscopic resection, necessitating surgical removal for a successful outcome.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Benign duodenal tumors are exceptionally rare, affecting 0.008% of the population.
- Brunner's gland adenomas constitute 11% of these rare duodenal neoplasms.
- While often asymptomatic, duodenal tumors can present with varied symptoms, making resection crucial for preventing complications.
Observation:
- A 59-year-old male presented with bloating, weight loss, and gastrointestinal bleeding nine months post-endoscopic resection of a Brunner's gland adenoma.
- Diagnostic imaging revealed a large 10x4cm mass obstructing the duodenum, precluding endoscopic management.
- The patient had a prior history of endoscopic resection for a 2x1.5cm Brunner's gland adenoma.
Findings:
- Recurrence of Brunner's gland adenoma after endoscopic resection, though previously unreported, was observed.
- Surgical intervention was required due to the significant tumor size and duodenal obstruction.
- Complete surgical removal resulted in an excellent outcome with no recurrence at 30 months post-surgery.
Implications:
- This case highlights the potential for recurrence of Brunner's gland adenomas, even after initial endoscopic resection.
- It underscores the importance of considering surgical management for large or recurrent duodenal tumors.
- Long-term surveillance may be warranted for patients with a history of Brunner's gland adenomas.