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.


METHODS
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.


CONCLUSIONS
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.
Lucidi
V
V
Medicosurgical Department of Hepatogastroenterology, Hôpital Erasme, Universite Libre de Bruxelles, 808 route de Lennik, 1070 Brussels, Belgium.
Van Laethem
J L
JL
Sersté
T
T
Gelin
M
M
Donckier
V
V
D000714:Anastomosis, Surgical / Q000379:methods; D001650:Bile Duct Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006500:Hepatic Duct, Common / Q000601:surgery; D006801:Humans; D007565:Jaundice / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D007583:Jejunum / Q000601:surgery; D018285:Klatskin Tumor / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery