Klatskin tumor

Klatskin tumor is a term that was traditionally given to a hilar cholangiocarcinoma, occurring at the bifurcation of the common hepatic duct. Typically, these tumors are small, poorly differentiated, exhibit aggressive biologic behavior, and tend to obstruct the intrahepatic bile ducts.

They are thought to account for up to 25% of all cholangiocarcinomas 1.

For general imaging features of a cholangiocarcinoma refer to the main article.

The presence of a hilar mass with obstruction would raise concern on ultrasound. The reported echotexture according to one study was 5:

  • increased echogenicity relative to surrounding liver ~80%
  • reduced echogenicity ~20%
  • mixed echogenicity ~2%

Ultrasound may also show an intraluminal mass extending into the bile duct and in a small proportion of cases (4%), there may also be evidence of bile duct wall thickening.

CT demonstrates the intrahepatic biliary radicle dilatation. The tumor mass itself is ill-defined and usually invisible however hilar necrotic lymph nodes or hepatic metastatic deposits could be identified. MRCP with its 3D capability is superior to CT to delineate the degree and location of the biliary tree stricture.

The gold standard method for diagnosis of hilar cholangiocarcinoma. Shouldering and abrupt tapering at the stricture site suggest the diagnosis. Identifying the exact location and involvement can help in preoperative classification.

Determine the exact location of the tumor mass and can be used in the preoperative assessment. The Bismuth-Corlette system is one classification:

  • type I: the lesion is limited to the common hepatic duct distal to the confluence of the right and left ducts
  • type II: the tumor involves the confluence of the right and left hepatic ducts
  • type III: the tumor involves one of the hepatic ducts
  • type IV: the tumor invades the right and left hepatic ducts and hence it becomes unresectable

For more discussion on staging see "cholangiocarcinoma staging".

It is named after Gerald Klatskin (1910-86), American pathologist, New York.

Imaging differential considerations include:

Article information

rID: 17177
Synonyms or Alternate Spellings:
  • Klatskin tumours
  • Klatskin tumor
  • Klatskin tumor's
  • Klatskin's tumor
  • Klatskin's tumour
  • Klatskin's tumours
  • Klatskin's tumors
  • Hilar cholangiocarcinoma
  • Hilar cholangiocarcinomas

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Cases and figures

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  • Case 2
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  • Case 5
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  • Case 6: type IIIA
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