[Hilar cholangiocarcinoma (Klatskin's tumor): up-to-date radiologic diagnosis, intervention and treatment possibilities].
METHODS
A 53-year-old man with jaundice was referred with suspected cholangiocarcinoma of the porta hepatis. He was found to be in a reduced general and nutritional condition. Cholinesterase was decreased, total bilirubin, GOT, GPT and alkaline phosphatase were increased.


METHODS
Abdominal contrast-enhanced computed tomography revealed a centrally located and contrast-enhancing mass at the proximal common hepatic duct. Metastases were not detectable. Endoscopic retrograde cholangiography showed a stenosis of the proximal common hepatic duct. An additional magnetic resonance tomography with cholangio-pancreatography confirmed the centrally located tumor as well as the stenosis of the common hepatic duct.


METHODS
The diagnostic tests were suggestive of a stage IV cholangiocarcinoma of the porta hepatis (Klatskin's tumor). The origin was subsequently proven histologically. There was no evidence of intra- or extrahepatic metastases. An interventional embolization of the right portal vein was performed preoperatively to stimulate the growth of the left hepatic lobe. But before surgery could take place a percutaneous transhepatic cholangiography and biliary drainage had to be done followed by an extended right-sided hemihepatectomy. During a 12 month follow-up no recurrence was observed.


CONCLUSIONS
Klatskin's tumor is rare and requires interdisciplinary collaboration. Recent developments in diagnostic, interventional and surgical methods result in a better prognosis.
Goltz
J P
JP
Institut für Röntgendiagnostik der Universität Würzburg. goltz@roentgen.uni-wuerzburg.de
Kenn
W
W
Hahn
D
D
Ritter
C O
CO
D015901:Angiography, Digital Subtraction; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003937:Diagnosis, Differential; D004322:Drainage; D004621:Embolization, Therapeutic; D006498:Hepatectomy; D006500:Hepatic Duct, Common / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D018285:Klatskin Tumor / Q000175:diagnosis* / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D015641:Radiography, Interventional; D015607:Stents; D014057:Tomography, X-Ray Computed