Peripheral Cholangiocarcinoma with Endoluminal Tumor Thrombus in Main Bile Duct Mimicking a Klatskin Tumor

Background Peripheral cholangiocarcinoma with endobiliary thrombus could be confused with Klatskin tumor, eventually leading to inappropriate therapeutic decision. Case report A 56-year-old man presented with an obstructive jaundice. Preoperative magnetic resonance imaging (MRI) showed a segment 7 l...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2008-06, Vol.12 (6), p.1149-1150
Main Authors: Lucidi, V., Van Laethem, J. L., Sersté, T., Gelin, M., Donckier, V.
Format: Article
Language:English
Subjects:
Anastomosis, Surgical - methods
Bile Duct Neoplasms - complications
Bile Duct Neoplasms - diagnosis
Bile Duct Neoplasms - surgery
Bile Ducts, Intrahepatic
Blood clots
Cholangiocarcinoma - complications
Cholangiocarcinoma - diagnosis
Cholangiocarcinoma - surgery
Diagnosis, Differential
Follow-Up Studies
Gastroenterology
Hepatectomy - methods
Hepatic Duct, Common - surgery
Humans
Jaundice - diagnosis
Jaundice - etiology
Jaundice - surgery
Jejunum - surgery
Klatskin Tumor - diagnosis
Male
Medical treatment
Medicine
Medicine & Public Health
Middle Aged
Surgery
Thrombosis - complications
Thrombosis - diagnosis
Thrombosis - surgery
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Summary:Background Peripheral cholangiocarcinoma with endobiliary thrombus could be confused with Klatskin tumor, eventually leading to inappropriate therapeutic decision. Case report A 56-year-old man presented with an obstructive jaundice. Preoperative magnetic resonance imaging (MRI) showed a segment 7 liver tumor associated with a complete stop at the biliary bifurcation compatible with a Klatskin tumor. Surgical exploration revealed that biliary obstruction was caused by endobiliary tumor-related thrombus. A right hepatectomy was performed, allowing complete endobiliary thrombus extraction. At pathology, a T2N0 intrahepatic cholangiocarcinoma was demonstrated. No adjuvant chemotherapy was given and currently, 22 months after surgery, the patient remains disease free. Discussion This case underlines the fact that intraductal growth of peripheral cholangiocarcinoma does not represent a contraindication for surgical treatment. MRI could be useful to differentiate such presentation of peripheral cholangiocracinoma from Klatskin tumor and orientate the surgical treatment.
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-007-0307-8