Klatskin tumor: type 2 sec. Bismuth

Case contributed by Dr Domenico Nicoletti


Right upper quadrant pain

Patient Data

Age: 77
Gender: Male

Cholangiopancreatography MRI with contrast medium

Concentric wall thickening, stenosing, with enhancement, of the proximal portion of the main bile duct, extended cranially at the confluence of hepatic ducts with associated discrete dilatation of the intrahepatic bile ducts. There are modest signs of arterialization the hepatic circulation in the second segment. The common bile duct is not dilated. Liver without focal lesions. In the pancreas are appreciable numerous cystic lesions in continuity with the main pancreatic duct referable to IPMN of secondary ducts. It should be noted pancreas divisum with Santorinicele. The Wirsung duct is not dilated.


Histological report

Case Discussion

The Klatskin tumors arise at the level of the bifurcation of the hepatic ducts, usually between the 5th and 7th decade of life, more frequent in males. Jaundice is the main symptom. Other signs are abdominal pain and weight loss. There are frequent regional lymph node metastasis. In 90% of cases, Klatskin tumors are sporadic, even if they have been associated with certain risk factors, including primary sclerosing cholangitis, cholangitis secondary sclerosing, chronic carriers of typhoid, parasitic infections (Opisthochis viverrini and Clonorchis sinensis ), exposure to thorotrast and cysts of the bile duct, causing chronic biliary inflammation


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Case information

rID: 52498
Published: 9th Jun 2017
Last edited: 9th Jun 2017
System: Oncology
Inclusion in quiz mode: Excluded

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