Authors: VANNELLA Lucy, LUCIDI Cristina, Roma, Italy

A 82-year-old patient underwent upper GI endoscopy for dispeptic symptoms. The examination showed a polypoid lesion originating from the duodenal bulb prolapsing through the pylorus. Biopsies were not taken due to inadequate DOAC discontinuation. The patient was referred to our Unit, where a EUS was performed to further characterize the lesion. EUS revealed a 15x8 mm hypoecoic, homogeneous lesion with regular margins, originating from the submucosal layer with vascular signal at the e-flow evaluation. Endoscopic biopsies were obtained instead of FNB because recent blood test results were unavailable. They were diagnostic for Brunner gland adenoma (Brunneroma). Given the benign nature of the lesion, patient’s age and comorbidities, conservative management was proposed.