A 52-year-old man presented with recurrent right upper quadrant pain of >10 months’ duration. His abdomen was soft, with no tenderness or rebound tenderness. Laboratory tests showed increased white blood cells, serum amylase and lipase levels, and erythrocyte sedimentation rate. Computed tomography revealed obvious thickening of the wall of the second portion of the duodenum by a soft tissue mass showing contrast enhancement (Figure 1A-C). Magnetic resonance imaging revealed a 3.1×3.7-cm duodenal mass, with significant contrast enhancement, and dilatation of the intrahepatic bile ducts, common hepatic duct, and proximal common bile duct (Figure 1D). During pancreaticoduodenectomy, we resected a palpable, soft, moveable duodenal mass measuring 5×6×2 cm. Histology showed large areas of hyperplastic fat acini with abundant eosinophilic cytoplasm. Smooth muscle was interspersed between the acini, and nodules were present (Figure 1E,F). We diagnosed Brunner’s gland adenoma.
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