1/9. carcinoid tumor of the hepatic duct presenting as a Klatskin tumor in an adolescent and review of world literature.This is a case presentation of a 14-year-old boy with the radiological diagnosis of cholangiocarcinoma occluding the hepatic duct bifurcation. His only symptom at presentation was jaundice and further workup confirmed a mass at the porta hepatis. Surgical treatment resulted in a resection of the hepatic bifurcation tumor with a final pathological diagnosis of a carcinoid tumor of the hepatic duct bifurcation. To our knowledge, this is only the second case presented of a resected carcinoid tumor in adolescence. In this communique we present the above case and review of the world literature of biliary neuroendocrine tumors.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/9. granular cell tumor at the hepatic duct confluence mimicking Klatskin tumor. A report of two cases and a review of the literature.BACKGROUND: Granular cell tumors are rare tumors most often located in the oral cavity, skin or subcutaneous tissue. The occurrence of this tumor in the biliary tree is extremely rare. methods: Two patients are described presenting with biliary obstruction due to a tumor at the hepatic duct confluence. One patient is a 38-year-old white male with concomitant cutaneous granular cell tumors, and the other a 50-year-old white female. RESULTS: Hilar excision was performed in both patients. Histopathology of the tumors revealed a proliferation of cells with granular cytoplasm, diagnosed as granular cell tumor. CONCLUSION: At preoperative examination, hilar granular cell tumors are difficult to differentiate from cholangiocarcinoma, sclerosing cholangitis or more common benign biliary tumors. Treatment consists of surgical excision after which prognosis is favorable.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
3/9. The longest survivor and first potential cure of an advanced cholangiocarcinoma by ex vivo resection and autotransplantation: a case report and review of the literature.bismuth type IV hilar cholangiocarcinoma (CC) carries a poor prognosis; however, ex vivo liver resection and autotransplantation (Atx) is theoretically a treatment option. There are only five previously reported cases of this procedure for hilar CC in the English literature, and most of them died early in the postoperative period. The only reported survivor died of tumor recurrence at 13 months. We are reporting a patient who has survived for 17 months without any sign of tumor recurrence. This probably represents the world's first cure for CC using this technique. This patient is a 26-year-old woman with a bismuth Type IV CC. portal vein involvement at the confluence was shown on angiogram, and in situ resection was deemed impossible. Ex vivo resection of segments five, six, seven, eight, and part of segment four was performed followed by a partial liver Atx. The pathology specimen demonstrated CC with clear margins. MRI and CT examinations done over the subsequent 17 months showed no evidence of recurrence. In conclusion ex vivo liver resection and Atx can be a viable option for cure among highly selected patients with CC.- - - - - - - - - - ranking = 5keywords = carcinoma (Clic here for more details about this article) |
4/9. Calcified Klatskin tumor mimicking intrahepatic stone: case report.Calcification is a relatively uncommon manifestation of malignant liver neoplasm. Calcifications in peripheral cholangiocarcinomas but not in Klatskin tumor have been reported. We present a rare case of Klatskin tumor that had dystrophic calcification mimicking a intrahepatic stone in a 65-year-old man.- - - - - - - - - - ranking = 1.0406402376675keywords = carcinoma, neoplasm (Clic here for more details about this article) |
5/9. Klatskin tumor treated by inter-disciplinary therapies including stereotactic radiotherapy: a case report.In view of the poor prognosis of patients with cholangiocarcinoma (CCC), there is a need for new therapeutic strategies. Inter-disciplinary therapy seems to be most promising. radiotherapy is an effective alternative to surgery for hilar CCC (Klatskin tumors) if an adequate radiation dose can be delivered to the liver hilus. Here, we describe a patient for whom we used a stereotactic radiotherapy technique in the context of an inter-disciplinary treatment concept. We report a 45-year-old patient with a locally advanced Klatskin tumor. Explorative laparotomy showed that the tumor was not resectable. A metallic stent was implanted and the patient was treated by stereotactic radiotherapy using a body frame. A total dose of 48 Gy (3X4 Gy/wk) was administered. Therapy was well tolerated. After 32 mo, local tumor recurrence and a chest wall metastasis developed and were controlled by radio-chemotherapy. After more than 56 mo with a good quality of life, the patient died of advanced neoplastic disease. Stereotactic radiotherapy led to a long-term survival of this patient with a locally advanced Klatskin tumor. In the context of inter-disciplinary treatment concepts, this radiotherapy technique is a promising choice of treatment for patients with hilar CCC.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
6/9. hemobilia secondary to hepatic artery pseudoaneurysm: an unusual complication of bile leakage in a patient with a history of a resected IIIb Klatskin tumor.We report a case of a 74-year-old woman with a 16-year history of a double bilo-enteric anastomosis due to resected hilar cholangiocarcinoma (Type IIIb Klatskin tumor). The patient presented with cholangitis secondary to benign anastomotic stenosis which resulted in a large intrahepatic biloma. In order to restore the patency of the anastomosis and overcome cholangitis, several attempts took place, including endobiliary stenting, balloon-assisted biloplasty and transhepatic billiary drainage. Anastomotic patency was achieved, complicated, however, by persistent upper gastro-intestinal bleeding, presented as hemobilia. A biloma-induced pseudoaneurysm of the left hepatic artery was diagnosed. This had ruptured into the biliary tract, and presented the actual cause of the hemobilia. Selective embolism of the pseudoaneurysm resulted in control of the hemorrhage, and was successfully combined with transhepatic dilatation of the anastomosis and percutaneous drainage of the biloma. The patient was ultimately cured and seems to be in excellent condition, 5 mo after treatment.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
7/9. A new method to obtain a tissue diagnosis of proximal bile duct tumors.Klatskin tumors often pose a challenge for diagnosis and treatment. Most of these neoplasms are diagnosed clinically because of the difficulty in obtaining tissue that will provide histologic proof of the disease. When a non-operative course is sought, exhaustive attempts should be made to obtain a tissue diagnosis because of the potential for a false-positive clinical diagnosis. We describe a new way to obtain tissue for diagnosis by placing a laparoscopic choledochoscope through a percutaneous transhepatic cholangiogram track, thus allowing the tumor to be directly visualized and biopsied.- - - - - - - - - - ranking = 0.040640237667529keywords = neoplasm (Clic here for more details about this article) |
8/9. Leptomeningeal carcinomatosis: a sequela of cholangiocarcinoma.Leptomeningeal carcinomatosis is a rare and deceptive presentation of systemic cancer. We report the treatment of a patient with a klatskin's tumor by surgical resection. The patient presented with symptoms suggestive of liver failure in the early postoperative period. He rapidly developed progressive, multineuroaxis symptoms and died. Routine gastrointestinal evaluation failed to demonstrate any intraabdominal pathologic process that could be responsible for his decline. A MRI of the brain was also unremarkable. Serial lumbar punctures, however, documented leptomeningeal carcinomatosis consistent with a gastrointestinal primary. The clinical presentation of leptomeningeal carcinomatosis is subtle and may masquerade as another disease state. The hallmark of this lethal process is the finding of progressive neurologic deficits at more than one level of the neuroaxis. Serial cerebrospinal fluid examination is often diagnostic. This is the first known report of leptomeningeal carcinomatosis secondary to primary cholangiocarcinoma.- - - - - - - - - - ranking = 162.24327888101keywords = carcinomatosis, carcinoma (Clic here for more details about this article) |
9/9. Primary extranodal non-Hodgkin lymphoma of the extrahepatic bile duct mimmicking Klatskin tumor.This report describes one case of primary non-Hodgkin lymphoma of the extrahepatic biliary tree. The main symptom was obstructive jaundice. cholangiography demonstrated stricture of the bile duct which resembled the appearance of cholangiocarcinoma. The surgical approach allowed complete ressection. The histopathological analyses showed a centrocitic-centroblastic follicular non-Hodgkin lymphoma. She underwent chemotherapy, developed severe bone marrow hypoplasia, but 48 months after surgery, the patient is doing well.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |