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అందరికి ప్రవేశం

నైరూప్య

Pyloric Giant Brunner's Gland Adenoma Mimicking Duodenal Carcinoma

Savitha Anil Kumar, Simi Ajesh and Shilpa Prabhudesai

Brunner’s gland adenoma is a rare benign tumor with 5% of tumors arising from the pyloric region of the small intestine. It is usually asymptomatic, but sometimes presents with ambiguous symptoms like nausea, vomiting, bloating, abdominal discomfort and luminal obstruction thus mimicking malignant tumors as well as other benign tumors that leads the treating physician to misdiagnose the lesion. Here, we present a case of a 62-year-old male with a history of weight loss and vomiting since 4 months. Initial imaging studies that revealed a large mass in the duodenum and endoscopic findings that suggested a mass arising from the pylorus and obstructing the lumen led to the clinical diagnosis of duodenal carcinoma/lymphoma. However, the endoscopic biopsy did not show any features of malignancy. Following laparotomic excision and histopathological examination, a final diagnosis of Brunner’s gland adenoma was made. To conclude, the ambiguous presentation of Brunner’s gland adenoma as well as its size make it a pertinent lesion to include in the differential diagnosis of malignancies.