Giant Brunneroma as an unusual cause of upper gastrointestinal hemorrhage: report of a case

Brunneroma, also known as Brunner's gland adenoma or harmartoma, is a rare, benign, proliferative lesion arising from the Brunner's glands of the duodenum, usually discovered incidentally at endoscopy. Occasionally, these lesions manifest as a rare cause of duodenal obstruction or upper gastrointestinal hemorrhage, and require excision. We report a case of an unusually large Brunneroma in a patient who presented with fresh melena and anemia. Although endoscopic polypectomy is the treatment of choice, we decided to perform surgical polypectomy through a laparotomy due to the huge dimensions of the lesion. The clinical and endoscopic features of this benign tumor and the therapeutic options are critically reviewed.