Cholangiocarcinoma - Klatskin

Case contributed by Michael P. Hartung
Diagnosis almost certain

Presentation

Abdominal pain.

Patient Data

Age: 45 years
Gender: Male
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Sagittal C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
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Focal waist-like thickening of the common hepatic duct just beyond the bifurcation of the right and left hepatic ducts, resulting in biliary obstruction and severe biliary ductal dilation. There is a relatively subtle, masslike area of hypoenhancement in hepatic segment 5 marginating the gallbladder fossa. No other masses in the liver. Porta hepatis adenopathy.

Case Discussion

Klatskin cholangiocarcinoma with focal waist like thickening of the common hepatic duct, resulting in severe biliary obstruction. There is a component of the tumor extending into the hepatic parenchyma in hepatic segment 5. There is also suspicious porta hepatis adenopathy.

The next step in management is endoscopy with stenting and brushing/biopsy, which was performed in this case and confirmed the diagnosis.

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