Definition of klatskin tumor nci dictionary of cancer terms. All types of cancerous growth in the biliary duct are termed as cholangiocarcinoma. Diagnosing klatskin cancer can be hard, and you may need to have some tests done including. A case of inoperable klatskin tumor showing response to wild. I was diagnosed in september with a klatskin tumor it is a type of cholangio carcinoma. Klatskin tumor is malignant cholangiocarcinoma arising from extrahepatic bile duct near the confluence of left and right hepatic ducts. Methods a population cohort study was conducted in patients selected from the surveillance, epidemiology, and end. Abdominal ct scans showed neither liver compromise nor compromise of the lymph nodes, nor vascular involvement. Jaundice is usually the symptom prompting a person to seek medical attention.
Perihilar cholangiocarcinoma also known as a klatskin tumor begins in an area called the hilum, where two major bile ducts join and leave the liver. The nci dictionary of cancer terms features 8,547 terms related to cancer and medicine. After a ercp they came to the conclusion that it has to be a klatskin tumor due to the location of the tissue the upper bile duct and part of the liver. Oct 24, 2011 a klatskin tumor, also known as hilar cholangiocarcinoma, is a cholangiocarcinoma cancer of the biliary tree occurring at the confluence of the right and left hepatic bile ducts.
Although surgical resection is the treatment of choice if possible, the prognosis is very poor after the surgery. There are a number of inflammatory, infective, vascular, and other pathologies, which have overlapping clinical and radiological features with a klatskin tumour, leading to misinterpretation. Klatskin tumor is an extrahepatic cholangiocarcinoma cca, see this term. The median cancerspecific survival in the klatskin tumor group was 10 months compared with 34 months in the icca group p tumor was removed, while in 36 patients 33% gross tumor was left behind after resection.
I read this tumor is rare, but it sure sounds like there are lots of us out there with this type of. Klatskin tumor is quite rare, more in male sex in age 60 years. Klatskin tumor genetic and rare diseases information center. In the left and right biliary system wires were placed. Klatskin tumors are are a type of cholangiocarcinoma that begins in an area called the hilum, where the left and right bile ducts join and leave the liver. Survival and quality of life of cholangiocarcinoma patients. Surgical treatment of hilar cholangiocarcinoma klatskin tumours is difficult because of its central location in the liver hilum.
Usually large, nonencapsulated, well demarcated, firm due to desmoplastic reaction, whitetan to gray and nodular intrahepatic mass. Klatskin definition of klatskin by medical dictionary. Cholangiocarcinoma staging is dependent on whether the tumor is primarily intrahepatic icc, hilarperihilar klatskin, or extrahepatic tumor resection is currently the most optimal treatment and the ability of the tumor to infiltrate longitudinally and radially along the biliary tree necessitates aggressive resection strategies such as ipsilateral hepatectomy. While there is no official known cause for klatskin tumors in the bile duct, there are some risk factors that have been associated with a small percentage of those diagnosed because they are known to cause biliary inflammation and may be related to klatskin tumor formation. The current understanding of these tumors is limited to a small number of case reports or case series.
Klatskin tumor is a type of cancerous growth develops at the junction between right and left biliary duct from where main bile duct is formed. Pdf benign biliary inflammatory pseudotumor mimicking a. A klatskin tumor or hilar cholangiocarcinoma is a cholangiocarcinoma cancer of the biliary tree occurring at the confluence of the right and left hepatic bile ducts. Typically, these tumors are small, poorly differentiated, exhibit aggressive biologic behavior, and tend. Tumor involving the confluence of the right and left hepatic ducts is known as klatskin tumor. Once the diagnosis of klatskin tumor was confirmed on cholangiogram, endoscopic stenting was performed to.
Nederlands tijdschrift voor geneeskunde, 14127, 3137. Klatskin tumor synonyms, klatskin tumor pronunciation, klatskin tumor translation, english dictionary definition of klatskin tumor. I have had an ultrasound, ct scan, and mrcp so far. Due to the high location of the hilar tumor an endos. Mar 27, 2005 hi jackie, after several echographic tests and ctscans there was still nothing visualized. Cholangiocarcinoma of the hepatic hilum klatskin tumor. Klatskin tumor patients than in patients with other types of tumors. Since the description by klatskin in 1965, the management of patients with adenocarcinoma of the hepatic bile duct bifurcation is viewed as a challenging clinical problem with a relatively poor prognosis. Cholangiocarcinoma staging radiology reference article. Liver function is impaired as a result of cholestasis, and this is an important risk factor in large liver resections. Klatskin tumor definition of klatskin tumor by medical. B, transverse image at the biliary confluence reveals an echogenic mass arrow at the bifurcation and dilated bile ducts in both lobes.
It is the most common type of cholangiocarcinoma, accounting for more than half of all cases. Endoscopic palliative therapy allowed a faster community reintegration, but with variable evolution. Preoperative evaluation of resectability of klatskin tumor. Cancer staging manual ajcc american joint committee on cancer 7ed. From my understanding, i thought that because of the strategic location of the klatskin tumor, it can cause obstruction and hence an earlier presentation by the patient with jaundice and thus these tmors can be resected with a much more reasonable and better prognosis compared to most cholangiocarcinomas. Benign biliary inflammatory pseudotumor mimicking a klatskin tumor. This paper aims to summarise the features of such klatskin like lesions that have been reported in surgical literature. It was his dream to create a histological atlas of diseases of the liver, an ambition brought to fruition in 1993 by harold conn, his first fellow and longtime collaborator at yale. Nomograms predict survival outcome of klatskin tumors. During surgery they dicovered the liver was infected by 80%. Quadruplephase mdct of the liver in patients with suspected hepatocellular carcinoma. Both parts were injected through a tube with contrast. Comprometimento linfonodal perihilar hepatico e do retroperitonio no estadiamento.
Of the 196 patients with klatskin tumors undergoing operative exploration, 8 4. Pdf diagnosis and management of klatskin tumor researchgate. Pdf most biliary tumors at the liver hilum are malignant and, when possible, require radical. Klatskin tumor is a cholangiocarcinoma in bifurcatio areas and related to poor prognosis. Typically, these tumors are small, poorly differentiated, exhibit aggressive biologic behavior, and tend to obstruct the intrahepatic bile ducts. Slightly longer survival was recorded when chemotherapy was added and also after endoscopic placement of metallic stents. Klatskin tumor symptoms typically include jaundice extreme yellowing of the skin, claycolored stools due to lack of bile drainage into the digestive system, bilirubinuria dark urine, itchy skin, weight loss, and abdominal pain. In 1965, klatskin identified cases of adenocarcinoma in the hepatic duct bifurcation and named this tumor type the klatskin tumor, or hilar cholangiocarcinoma hcca okuda et al. We offer a widget that you can add to your website to let users look up cancerrelated terms. Any information contained in this pdf file is automatically generated from digital. Jul 23, 20 klatskin tumor is known to be highly resistant to conventional chemotherapy and radiotherapy.
Preoperative evaluation of resectability of klatskin tumor with 16mdct angiography and cholangiography original research. Among this almost 60% to 70 % biliary duct cancer is klatskin tumor 1,2. Objective klatskin tumors are rare, malignant tumors of the biliary system with a poor prognosis for patient survival. Hilar cholangiocarcinoma klatskin tumor 117 showed no pulmonary parenchymal or pleural eff usion. Nomograms predict survival outcome of klatskin tumors patients. After extensive internet searches, im glad to find this site. Bile duct cancer of the upper part of the bile duct is also called klatskins tumor. Klatskin tumor definition of klatskin tumor by the free. Satellite nodules are present in 30% calcification is common. But, since tumor markers can be caused by other conditions, this test isn.
Klatskin tumor is a term that was traditionally given to a hilar cholangiocarcinoma, occurring at the bifurcation of the common hepatic duct. There is prooved connection between this malignant tumor and primary sclerosis cholangitis autoimmune disease and parasitic infection in biliary ducts clonorchis sinensis and opisthorchis viverrini, both in southeast asia. The lack of contrast in the area of the confluence is clearly visible. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Complete resection of the tumor with negative histologic margins offers the best possibility of longterm survival, and hepatic resection is a. Perihilar bile duct tumors can be further classified as type 1 through type 4, depending on the site of involvement of the ducts. This is the least common form of the disease, accounting for less than 10 percent of all cases. Therapeutical concepts and results for klatskin tumors. Most relevant publications describing the resection of klatskin tumors recommend preoperative decompression of the biliary duct, aiming to reduce bilirubin measurements to below 2 mgdl or 5 mgdl 2, 7, 8, 1012.
Another classification groups biliary tract cancers as intrahepatic, perihilar and distal extrahepatic. With klatskin tumors, the cancerous cells may release certain chemicals known as tumor markers that can be detected using blood tests. A, longitudinal view of the common hepatic duct shows a tapered segment arrow consistent with tumor stricture. Whether an endoscopic or percutaneous transhepatic approach is favored depends on the center. I will be having an ercp this friday to get a biopsy and see how much blockage there is. Demographics, tumor characteristics, treatment, and survival of patients with klatskin tumors. In 1965 he described the unique features of cholangiocarcinoma at the bifurcation of the main intrahepatic bile ducts, which came to be called the klatskin tumor. Recent developments in surgical techniques have improved the. Bile duct cancer klatskin tumor liver and pancreas surgeon. Grossly classified into 3 types in some articles world j. Klatskin tumors occur in the hepatic duct bifurcation, usually presenting in the. Extrahepatic biliary cystadenocarcinoma mimicking klatskin tumor.
Feb 18, 2020 the median os in the klatskin tumor group was 5 months compared with 26 and 68 months in the icca and hcc groups, respectively. Any information contained in this pdf file is automatically generated from digital material submitted to epos by third parties in the form of scientific presentations. Pdf on apr 1, 2010, dicky levenus tahapary and others published diagnosis and management of klatskin tumor. Doppler ultrasound showed normal portal venous blood fl ow. A klatskin tumor or hilar cholangiocarcinoma is a cholangiocarcinoma occurring at the confluence of the right and left hepatic bile ducts. The disease was named after gerald klatskin, who in 1965 described 15 cases and found some characteristics for this type of cholangiocarcinoma. Intrahepatic cholangiocarcinoma begins in the small bile ducts within the liver. In this report, we present an unusual case of 57yearold woman who has been living for more than 4. Mark fraiman, md st joseph medical center liver and pancreas center 23,239 views. Cateteres en conducto hepatico derecho e izquierdo con. Kat not real name is a 64yearold indonesian lady from aceh. Oct, 2016 klatskin tumors are are a type of cholangiocarcinoma that begins in an area called the hilum, where the left and right bile ducts join and leave the liver. Hilar cholangiocarcinoma klatskin tumor scielo colombia.