A great Brunner's gland adenoma of the duodenal bulb

The occurrence of Brunner's gland adenoma in the duodenum is infrequent. The authors report a case of great Brunner's gland adenoma of the duodenal bulb, which is of interest because of its great size (8.5 X 4.5 cm) and the negative result of the endoscopic biopsy. Endoscopy has improved the diagnosis of the duodenal tumors; however, traditional endoscopic pinching biopsy does not always make a histological diagnosis. In our case, the endoscopic biopsy was negative because the tumor was located completely in the submucosa and the biopsy forceps was unable to reach to the tumor tissue.