Adenomatous Hyperplasia of Duodenal Brunner's Glands: An Extremely Uncommon Imitation of Malignant Pathology.

Adenomatous hyperplasia of duodenal Brunner's glands is a rare benign pathology of the duodenum linked to epigastric pain and dyspepsia. However, in rare cases, it can cause intestinal obstruction. Hence, endoscopic or surgical removal of Brunner's gland hyperplasia (BGH) has been suggested to prevent complications including hemorrhage, severe anemia due to persistent bleeding, intussusception, and obstruction. BGH can be managed with endoscopic polypectomy. It represents a less invasive alternative to surgery and is more cost-effective. The medical treatment mainly involves treating gastric hyperacidity, a known cause of BGH, but the regression of BGH is rare. This case report aims to describe and investigate the clinicopathologic features of this rare pathology. The case emphasizes the importance of endoscopy for the evaluation of the refractory gastroesophageal reflux-like presentation and demonstrates that histopathological evaluation remains critical for a definitive diagnosis of BGH and to rule out malignancy. Conservative approaches may suffice in select patients, avoiding invasive interventions. Follow-up remains essential to monitor for recurrence or complications.