ENDOSCOPIC RESECTION OF A LARGE SUB-EPITHELIAL TUMOR

Brunner's glands hamartomas (BGH) are rare and benign tumors that occur mainly in the duodenal bulb. They represent about 5 to 10% of benign duodenal tumors and have an estimated incidence of less than 0.01%. Most cases of GH have been reported between the ages of 40 – 60 years, with no gender predominance. BGH consist of an abnormal proliferation of Brunner's glands embedded in a fibrous stroma with bundles of smooth muscle and contain cystic dilated ducts. They appear pedunculated in the majority of cases and arise from the deep mucosa or submucosa. Although often asymptomatic, patients can also present anemia, gastrointestinal bleeding or obstruction. Removal of the suspected BGH, whether endoscopic or surgical, is recommended to both confirm the diagnosis and to avoid potential complications.