title: A Giant Brunneroma Causing Gastrointestinal Bleeding and Severe Anemia Requiring Transfusion and Surgery.
abstract: Brunner's gland hamartoma, also called hyperplasia, adenoma, and Brunneroma, is an extremely rare benign proliferative lesion of Brunner's glands in the duodenum. While being mostly small and asymptomatic, they can result in gastrointestinal bleeding and obstruction. We report the case of a 54-year-old man presenting with melena and severe anemia requiring blood transfusion. CT scans showed a large mass of 8 cm in diameter, presumably arising in the duodenum. Endoscopic biopsies were not conclusive. As we were unable to determine the nature of the mass preoperatively and due to the severe symptoms, its size, and the uncertain malignant potential, a classic Whipple procedure was performed. The resected specimen showed extensive proliferation of Brunner's glands without signs of malignancy.
authors.affiliation: Department of Surgery, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Nicola C
authors.identifier: 0000-0002-7574-240X
authors.initials: NC
authors.lastname: Frenkel
authors.affiliation: Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Miangela M
authors.initials: MM
authors.lastname: Laclé
authors.affiliation: Department of Surgery, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Inne H M
authors.initials: IH
authors.lastname: Borel Rinkes
authors.affiliation: Department of Surgery, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Izaak Q
authors.identifier: 0000-0002-1585-7184
authors.initials: IQ
authors.lastname: Molenaar
authors.affiliation: Department of Surgery, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Jeroen
authors.identifier: 0000-0001-8737-3923
authors.initials: J
authors.lastname: Hagendoorn