Endoscopic treatment of a large Brunner’s gland hamartoma in the duodenum

A 62-year-old woman visited our hospital for further evaluation of a large elongated polypoid mass in the duodenum, which was incidentally discovered during a health check-up endoscopy. The patient had a medical history of hypertension and hyperlipidemia. At endoscopy, a 10-cm subepithelial mass with a long stalk was observed in the second portion of the duodenum ([Fig. 1] a); nodular mucosal changes were observed in the distal portion of the mass ([Fig. 1] b). Endoscopic ultrasonography (EUS) revealed that the mass was a heterogeneously mixed echogenic lesion with cystic changes in the deep mucosal and submucosal layers [Fig. 1] c).