Brunneroma: an infrequent duodenal neoplasm

Area of Science:

• Gastroenterology
• Oncology
• Internal Medicine

Background:

• A common presentation of gastrointestinal distress in elderly patients can mask serious underlying conditions.
• Early detection of duodenal lesions is crucial for effective management and improved patient outcomes.

Observation:

• An 83-year-old male presented with chronic epigastric discomfort, unintended weight loss, and diarrhea.
• Initial physical examination and routine laboratory tests yielded unremarkable results.
• Upper gastrointestinal endoscopy was performed to investigate the persistent symptoms.

Findings:

• Endoscopy revealed a sessile lesion, classified as Paris 0-IIa, located on the anterior wall of the duodenal bulb.
• The lesion exhibited a smooth surface with minor superficial ulceration at its apex.
• This finding suggests a potential neoplastic or pre-neoplastic condition requiring further evaluation.

Implications:

• The identification of this duodenal lesion necessitates further histopathological examination to determine its nature (e.g., adenoma, adenocarcinoma).
• Prompt diagnosis and appropriate treatment are essential to manage the patient's symptoms and prevent disease progression.
• This case highlights the importance of thorough endoscopic evaluation in elderly patients presenting with non-specific gastrointestinal symptoms.