Brunner Gland Cyst: Two Cases of a Rare Entity and Review of the Literature

Adrienne E. Moul, Pablo A. Bejarano*, Afonso C. Ribeiro and Tolga Erim

Brunner Gland Cyst: Two Cases of a Rare Entity and Review of the Literature

Cystic lesions of the Brunner gland are rare.
They have been referred to as Brunner’s gland cyst, cystic Brunner’s
gland hamartoma, Brunner’s gland cystadenoma and mucocele of the Brunner gland.

Recently these entities have been grouped under the term Brunner gland
cyst. Even with these combined entities, there are only fourteen Brunner gland
cysts reported in the English literature.

We present two new cases of Brunner gland cyst and compared
them to those previously reported. Their clinical presentation and
similarities are summarized.

Endoscopic ultrasound showed a 17×6 mm septated cyst that appeared
to arise from the submucosa of the second portion of the duodenum.

The lesion appeared to originate from within the submucosa.
The possibilities of pancreatic rest or Brunner’s gland hyperplasia
were considered.

The lesion was hypoechoic, heterogeneous and multicystic
that measured 14.5 mm x 10.9 mm.

The cytoplasm was clear and abundant. In areas, there were aggregates
of glands by the single row of epithelial cells lining
the cysts creating a nodular configuration.

Brunner gland cysts are benign, as evidenced by the fact that
the lesion described by Golan, et al. was present for 15 years without any
long-term consequences.

The lesion can occur throughout the duodenum, specifically any
place that contains Brunner glands.

The large majority are single
lesions with one patient reported to have two.

Ultrastructural studies performed by Taura, et al. in 1977
demonstrated epithelial cells containing membrane-bound secretory
granules in the cytoplasm, mainly in the apical region, and a
well-developed Golgi apparatus.

The luminal surfaces contained microvilli. These features suggested
that the cells of Brunner gland cysts were functionally more active
than normal Brunner gland cells.

Gastro Open J. 2015; 1(3): 74-78. doi: 10.17140/GOJ-1-113