Brunner's gland hamartomas can mimic carcinoma of the head of the pancreas.

Three patients with Brunner's gland hamartomas had symptoms preoperatively and findings intraoperatively that were consistent with carcinoma of the head of the pancreas. It is important to differentiate between these two pathologic conditions because the operation required for the treatment of the two diseases is of a different order of magnitude. A diagnosis of a Brunner's gland hamartoma can be considered on the basis of the clinical history, physical findings, laboratory findings and the appearance of the duodenal mucosa surrounding the ampulla of Vater. Confirmation of the diagnosis can be made upon biopsy of the duodenum at operation.