Polypoid hamartoma of Brunner's gland of the duodenum

Background/Aims: Brunner's gland adenoma is an extremely rare but important entity. Controversy exists over its etiology and pathogenesis, but the pre sent view is that it is a duodenal hamartoma with a predominance of Brunner 's gland elements. Methods: A case of a 76-year-old woman with a reddish pe dunculated polyp prolapsing between the bulb and the second part of the duo denum seen at endoscopy and removed surgically through a longitudinal duode notomy is presented. Results: The cut surface of the tumor had a grayish co lor, revealing multiple cystic spaces which on microscopic examination prov ed to be enlarged Brunner's glands. The hyperplastic glands formed lobules which were surrounded by bundles of fibromuscular and connective tissue. In the adjacent duodenum, large numbers of lobules of well-differentiated Bru nner's glands with mucus-secreting epithelial cells were seen. Conclusion: The reported case supports the theory that Brunner's gland adenomas are duo denal hamartomas with a predominance of Brunner's gland elements and furthe r shows that a continuity exists in Brunner's glands of the tumor and those of the adjacent duodenum. Copyright (C) 1999 S. Karger AG, Basel.