Clinical Endoscopy

  • 제40권5호
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  • Pages.297-302
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  • 2010
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
권호 표지

거대 Brunner 종양 국내보고 39예의 임상적 고찰

Clinical Characteristics of Large Brunner's Gland Tumors in Korea

  • 강지훈 (동국대학교 의과대학 내과학교실) ;
  • 임윤정 (동국대학교 의과대학 내과학교실) ;
  • 한석재 (동국대학교 의과대학 내과학교실) ;
  • 최종순 (동국대학교 의과대학 병리학교실) ;
  • 고문수 (동국대학교 의과대학 내과학교실) ;
  • 이진호 (동국대학교 의과대학 내과학교실)
  • Kang, Ji-Hun (Department of Internal Medicine, Dongguk University College of Medicine) ;
  • Lim, Yun-Jeong (Department of Internal Medicine, Dongguk University College of Medicine) ;
  • Hahn, Suk-Jae (Department of Internal Medicine, Dongguk University College of Medicine) ;
  • Choi, Jong-Sun (Department of Pathology, Dongguk University College of Medicine) ;
  • Koh, Moon-Soo (Department of Internal Medicine, Dongguk University College of Medicine) ;
  • Lee, Jin-Ho (Department of Internal Medicine, Dongguk University College of Medicine)
  • 투고 : 2009.11.10
  • 심사 : 2010.03.25
  • 발행 : 2010.05.30
⟨ 이전 논문 다음 논문 ⟩

초록

목적: Brunner 종양은 흔한 양성 종양으로 십이지장에 존재하며 Brunner 과오종, 선종, 과증식으로도 부른다. 그러나, 직경 1 cm 이상의 Brunner 과오종, 선종, 과증식은 드물다. 대상 및 방법: 국내 학술지에 보고된 37예와 저자들이 경험한 2예를 토대로 1 cm 이상의 Brunner 종양의 임상적 특징을 알아보았다. 결과: 평균 나이는 52.6세였으며 40세 이후 뚜렷한 증가 추세가 관찰되었고 성별에 따른 차이는 없었다. 크기는 1 cm에서 8 cm으로 나타났고 평균 직경 2.9 cm이었으며 모양은 주로 유경성 용종으로 나타났다. 가장 흔한 위치는 구부였으며, 심와부 통증이 가장 흔한 증상이었다. Brunner 종양은 위장관 출혈 및 폐색 등 합병증으로 발견된다. 대부분의 용종은 점막 조직 검사에서 비 진단적인 병리학적 소견을 보이고 한 예에서만이 Brunner 종양에서 악성 변화를 관찰할 수 있었다. 치료로 대부분 내시경적 용종절제술 또는 점막하박리술이 안전하게 이루어졌으며 일부에서 수술적 제거로 이루어졌다. 제거 후에는 국소적 재발은 없었다. 결론: Brunner 종양은 심와부 동통이나 검진 목적으로 상부 위장관 내시경에서 대부분 우연히 발견되나 빈혈, 위장관 출혈, 폐색 등 합병증이 동반된다. 정확한 조직학적 진단과 치료를 위해 일차적으로 내시경적 용종절제술을 권고한다.

Background/Aims: Brunner's gland tumor is a common benign tumor noted in duodenum and might be designated as Brunner's gland hamartoma, adenoma or hyperplasia. But, a large duodenal polyp (over 1 cm in diameter) pathologically proven as a tumor of Brunner's gland origin is rare. Methods: We analyzed a total of 39 cases including our direct experience of two cases and reports of 37 cases to clarify the clinical features of large Brunner's gland tumors. Results: This tumor tends to present predominantly after the fourth decade: Median age is 52.6 years. Neither gender showed predominance. The size of the tumor ranged from 1 to 8 cm and the mean diameter was 2.9 cm. The most common location was the bulb. A pedunculated polyp was the common appearance. Epigastric pain was the most common symptom. Brunner's gland tumor can cause gastrointestinal hemorrhage or obstruction. Most of the polyps had non-diagnostic pathologic yield at pinch biopsy and only one case was diagnosed as focal adenocarcinoma. Endoscopic or surgical removal was undertaken for treatment. Most cases had no recurrence after removal. Snare polypectomy or submucosal dissection very safe and useful treatment modalities. Conclusions: Large Brunner's gland tumors are mostly found during a check up or epigastric pain. Anemia, melena and obstruction often develop. Endoscopic polypectomy is recommended as a first line treatment.

키워드

참고문헌

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