Brunner's gland hamartomas: Not always benign

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Brunner's gland hamartoma (BGH) is a rare, benign duodenal tumor, often incidentally discovered during esophagogastroduodenoscopy (EGD).
• While typically asymptomatic, BGH can manifest with significant complications such as anemia, gastrointestinal bleeding, obstruction, or dysplasia.

Approach:

• This report details two cases of large duodenal BGHs.
• One case presented with severe gastrointestinal bleeding.
• The second case, identified during EGD for iron deficiency anemia, revealed high-grade dysplasia.

Key Points:

• Brunner's gland hamartomas, though rare, can present with severe clinical manifestations.
• Complications include iron deficiency anemia, overt gastrointestinal bleeding, and the potential for malignant transformation.
• Prompt diagnosis and management are crucial for patients with symptomatic BGH.

Conclusions:

• Brunner's gland hamartomas require careful evaluation due to their potential for serious complications.
• The malignant potential of BGH, although low, underscores the importance of vigilance and appropriate resection when indicated.
• This review highlights the spectrum of BGH complications and their management implications.