KRAS G12D mutation in Brunner gland adenoma

Mahatma Ortega; Jessica Sparks; Jack Lichy; Victor E Nava

doi:10.1136/bcr-2022-252160

KRAS G12D mutation in Brunner gland adenoma

BMJ Case Rep. 2023 Jan 27;16(1):e252160. doi: 10.1136/bcr-2022-252160.

Authors

Mahatma Ortega¹, Jessica Sparks², Jack Lichy³, Victor E Nava⁴

Affiliations

¹ Pathology, George Washington University School of Public Health and Health Services, Washington, District of Columbia, USA.
² University of Louisville School of Medicine, Louisville, Kentucky, USA.
³ Department of Pathology, George Washington University, Washington, District of Columbia, USA.
⁴ Department of Pathology, George Washington University, Washington, District of Columbia, USA vnava1@gwu.edu.

PMID: 36707100
PMCID: PMC9884920 (available on 2025-01-26)
DOI: 10.1136/bcr-2022-252160

Abstract

Brunner gland lesions (BGLs) encompass benign proliferations of the homonymous glands and have been designated as hyperplasia, adenoma (BGA), hamartoma or nodule. In general terms, lesions larger than 0.5 cm are considered true neoplasia with unknown malignant potential and unclear pathogenesis. Genetic alterations have seldom been reported in BGL, and include SMAD4/DPC4 and LRIG1, but not KRAS (Kirsten rat sarcoma viral oncogene homologue) to the best of our knowledge.We present the case of a man in his 60s, evaluated for iron deficiency anaemia harbouring a 1.5 cm BGA found by duodenoscopy. Immunohistochemistry failed to reveal microsatellite instability, and next-generation sequencing revealed a KRAS G12D point mutation.

Keywords: Gastroenterology; Genetics; Pathology.

Publication types

Case Reports

MeSH terms

Adenoma* / diagnostic imaging
Adenoma* / genetics
Adenoma* / pathology
Brunner Glands* / pathology
Duodenal Neoplasms* / genetics
Duodenal Neoplasms* / pathology
Duodenoscopy
Humans
Mutation
Proto-Oncogene Proteins p21(ras) / genetics

Substances

KRAS protein, human
Proto-Oncogene Proteins p21(ras)