Klatskin's Tumor
Hepatic Duct, Common
Bile Ducts, Extrahepatic
Tumor Markers, Biological
Tumor Burden
Tumor Necrosis Factor-alpha
A Klatskin's tumor, also known as a perihilar cholangiocarcinoma, is a rare and aggressive form of cancer that occurs at the junction where the right and left hepatic ducts come together to form the common hepatic duct, which then becomes the common bile duct. This type of tumor can obstruct the flow of bile from the liver into the small intestine, leading to jaundice, itching, abdominal pain, and other symptoms. Klatskin's tumors are often difficult to diagnose and treat due to their location and tendency to spread quickly. Surgical resection is the preferred treatment option when possible, although chemotherapy and radiation therapy may also be used in some cases.
The common hepatic duct is a medical term that refers to the duct in the liver responsible for carrying bile from the liver. More specifically, it is the duct that results from the convergence of the right and left hepatic ducts, which themselves carry bile from the right and left lobes of the liver, respectively. The common hepatic duct then joins with the cystic duct from the gallbladder to form the common bile duct, which ultimately drains into the duodenum, a part of the small intestine.
The primary function of the common hepatic duct is to transport bile, a digestive juice produced by the liver, to the small intestine. Bile helps break down fats during the digestion process, making it possible for the body to absorb them properly. Any issues or abnormalities in the common hepatic duct can lead to problems with bile flow and potentially cause health complications such as jaundice, gallstones, or liver damage.
Bile duct neoplasms, also known as cholangiocarcinomas, refer to a group of malignancies that arise from the bile ducts. These are the tubes that carry bile from the liver to the gallbladder and small intestine. Bile duct neoplasms can be further classified based on their location as intrahepatic (within the liver), perihilar (at the junction of the left and right hepatic ducts), or distal (in the common bile duct).
These tumors are relatively rare, but their incidence has been increasing in recent years. They can cause a variety of symptoms, including jaundice, abdominal pain, weight loss, and fever. The diagnosis of bile duct neoplasms typically involves imaging studies such as CT or MRI scans, as well as blood tests to assess liver function. In some cases, a biopsy may be necessary to confirm the diagnosis.
Treatment options for bile duct neoplasms depend on several factors, including the location and stage of the tumor, as well as the patient's overall health. Surgical resection is the preferred treatment for early-stage tumors, while chemotherapy and radiation therapy may be used in more advanced cases. For patients who are not candidates for surgery, palliative treatments such as stenting or bypass procedures may be recommended to relieve symptoms and improve quality of life.
Extrahepatic bile ducts refer to the portion of the biliary system that lies outside the liver. The biliary system is responsible for producing, storing, and transporting bile, a digestive fluid produced by the liver.
The extrahepatic bile ducts include:
1. The common hepatic duct: This duct is formed by the union of the right and left hepatic ducts, which drain bile from the corresponding lobes of the liver.
2. The cystic duct: This short duct connects the gallbladder to the common hepatic duct, allowing bile to flow into the gallbladder for storage and concentration.
3. The common bile duct: This is the result of the fusion of the common hepatic duct and the cystic duct. It transports bile from the liver and gallbladder to the duodenum, the first part of the small intestine, where it aids in fat digestion.
4. The ampulla of Vater (or hepatopancreatic ampulla): This is a dilated area where the common bile duct and the pancreatic duct join and empty their contents into the duodenum through a shared opening called the major duodenal papilla.
Extrahepatic bile ducts can be affected by various conditions, such as gallstones, inflammation (cholangitis), strictures, or tumors, which may require medical or surgical intervention.
Tumor markers are substances that can be found in the body and their presence can indicate the presence of certain types of cancer or other conditions. Biological tumor markers refer to those substances that are produced by cancer cells or by other cells in response to cancer or certain benign (non-cancerous) conditions. These markers can be found in various bodily fluids such as blood, urine, or tissue samples.
Examples of biological tumor markers include:
1. Proteins: Some tumor markers are proteins that are produced by cancer cells or by other cells in response to the presence of cancer. For example, prostate-specific antigen (PSA) is a protein produced by normal prostate cells and in higher amounts by prostate cancer cells.
2. Genetic material: Tumor markers can also include genetic material such as DNA, RNA, or microRNA that are shed by cancer cells into bodily fluids. For example, circulating tumor DNA (ctDNA) is genetic material from cancer cells that can be found in the bloodstream.
3. Metabolites: Tumor markers can also include metabolic products produced by cancer cells or by other cells in response to cancer. For example, lactate dehydrogenase (LDH) is an enzyme that is released into the bloodstream when cancer cells break down glucose for energy.
It's important to note that tumor markers are not specific to cancer and can be elevated in non-cancerous conditions as well. Therefore, they should not be used alone to diagnose cancer but rather as a tool in conjunction with other diagnostic tests and clinical evaluations.
Tumor burden is a term used to describe the total amount of cancer in the body. It can refer to the number of tumors, the size of the tumors, or the amount of cancer cells in the body. In research and clinical trials, tumor burden is often measured to assess the effectiveness of treatments or to monitor disease progression. High tumor burden can cause various symptoms and complications, depending on the type and location of the cancer. It can also affect a person's prognosis and treatment options.
Tumor Necrosis Factor-alpha (TNF-α) is a cytokine, a type of small signaling protein involved in immune response and inflammation. It is primarily produced by activated macrophages, although other cell types such as T-cells, natural killer cells, and mast cells can also produce it.
TNF-α plays a crucial role in the body's defense against infection and tissue injury by mediating inflammatory responses, activating immune cells, and inducing apoptosis (programmed cell death) in certain types of cells. It does this by binding to its receptors, TNFR1 and TNFR2, which are found on the surface of many cell types.
In addition to its role in the immune response, TNF-α has been implicated in the pathogenesis of several diseases, including autoimmune disorders such as rheumatoid arthritis, inflammatory bowel disease, and psoriasis, as well as cancer, where it can promote tumor growth and metastasis.
Therapeutic agents that target TNF-α, such as infliximab, adalimumab, and etanercept, have been developed to treat these conditions. However, these drugs can also increase the risk of infections and other side effects, so their use must be carefully monitored.
A cell line that is derived from tumor cells and has been adapted to grow in culture. These cell lines are often used in research to study the characteristics of cancer cells, including their growth patterns, genetic changes, and responses to various treatments. They can be established from many different types of tumors, such as carcinomas, sarcomas, and leukemias. Once established, these cell lines can be grown and maintained indefinitely in the laboratory, allowing researchers to conduct experiments and studies that would not be feasible using primary tumor cells. It is important to note that tumor cell lines may not always accurately represent the behavior of the original tumor, as they can undergo genetic changes during their time in culture.
Klatskin tumor
Cholangiocarcinoma
Courvoisier's law
International Classification of Diseases for Oncology
List of eponymous diseases
Index of oncology articles
List of MeSH codes (C04)
Klatskin tumor - Wikipedia
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がん情報サイト | がん情報各論:[医療専門家向け]Bile Duct Cancer (Cholangiocarcinoma) Treatment
Tumors of the Gallbladder and Bile Ducts - Hepatic and Biliary Disorders - Merck Manuals Professional Edition
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Distal5
- [ 7 ] Distal extrahepatic tumors are located from the upper border of the pancreas to the ampulla. (medscape.com)
- [ 1 ] The classification of bile duct tumors has changed to include intrahepatic tumors of the bile ducts and extrahepatic tumors (perihilar and distal) of the bile ducts. (tri-kobe.org)
- Cholangiocarcinomas occur predominantly in the extrahepatic bile ducts: 60 to 70% in the perihilar region (Klatskin tumors), about 25% in the distal extrahepatic ducts, and the rest in the liver. (merckmanuals.com)
- Distal bile duct tumors are those arising between the junction of the cystic duct and the ampulla of Vater, including those arising in the intrapancreatic portion of the common bile duct. (cancer.gov)
- Extrahepatic tumors are divided into proximal, middle, and distal ductal tumors. (medscape.com)
Cholangiocarcinoma15
- A Klatskin tumor (or hilar cholangiocarcinoma) is a cholangiocarcinoma (cancer of the biliary tree) occurring at the confluence of the right and left hepatic bile ducts. (wikipedia.org)
- The disease was named after Gerald Klatskin, who in 1965 described 15 cases and found some characteristics for this type of cholangiocarcinoma The cause of cholangiocarcinoma has not been defined. (wikipedia.org)
- citation needed] Levels of the tumor markers carbohydrate antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA) and CA 125 are abnormally high in the bloodstreams of patients with intrahepatic cholangiocarcinoma and Klatskin tumor. (wikipedia.org)
- Klatskin's tumor (or hilar cholangiocarcinoma) is an extra-hepatic cholangiocarcinoma arising in the junction of the main right and left hepatic bile ducts. (unizg.hr)
- Cholangiocarcinoma is a malignant tumor that is found in the bile ducts. (picmonic.com)
- A Klatskin tumor (also known as hilar cholangiocarcinoma) is a special type of extrahepatic cholangiocarcinoma that arises at the junction of the right and left hepatic bile ducts. (mypathologyreport.ca)
- Metastatic cholangiocarcinoma means that tumour cells have spread from the bile duct to another part of the body such as a lymph node or the lungs. (mypathologyreport.ca)
- When examined under the microscope, cholangiocarcinoma is made up of medium to large-sized tumour cells that connect together to form gland-like structures that are often described as tubules or ducts. (mypathologyreport.ca)
- Well differentiated cholangiocarcinoma - More than 95% of the tumour is made up of glands. (mypathologyreport.ca)
- Moderately differentiated cholangiocarcinoma - 50 to 95% of the tumour is made up of glands. (mypathologyreport.ca)
- Poorly differentiated cholangiocarcinoma - Less than 50% of the tumour is made up of glands. (mypathologyreport.ca)
- More than one tumour increases the tumour stage (pT) for intrahepatic cholangiocarcinoma and is associated with a worse prognosis . (mypathologyreport.ca)
- Pathologists use the term tumour extension to describe how far the tumour cells in intrahepatic cholangiocarcinoma have spread through the bile ducts and liver. (mypathologyreport.ca)
- Tumour markers- The value of CA 19-9 in patients with suspected cholangiocarcinoma is unclear. (gastrotraining.com)
- Tissue diagnosis of cholangiocarcinoma is difficult because it is highly desmoplastic tumour composed of a few malignant cholangiocytes within excessive fibrous tissue. (gastrotraining.com)
Malignant3
- Carcinoid tumors account for 13-34% of small bowel tumors and 17-46% of malignant tumors of the small bowel. (medscape.com)
- Rarer still is carcinoid syndrome that develops in patients with noncarcinoid malignant tumors and dermatomyositis. (medscape.com)
- Other specified malignant neoplasm (Other specified cancer tumour Other codes are obsolete, ie the entities have been in the previous edition). (who.int)
Management of these tumors2
- Various challenges of coming up with effective management of these tumors affect efforts to improve the prognosis of these diseases in patients. (marijuanadoctors.com)
- The role of endoscopic and intraductal US in the management of these tumors is yet to be defined. (medscape.com)
Hepatocellular carcinoma2
- CC is the second commonest primary liver tumour worldwide, after hepatocellular carcinoma (HCC). (bmj.com)
- Traditionally, bile duct tumors located within the liver had been classified with hepatocellular carcinoma as primary liver tumors. (tri-kobe.org)
Unresectable3
- Stents usually are used if the tumor is unresectable or if the patient is not a surgical candidate. (medscape.com)
- In patients with medially inoperable or unresectable tumors, primary radiotherapy, with or without chemotherapy, has provided a survival advantage and significant palliation over stent placement or bypass surgery alone. (medscape.com)
- Currently, surgical resection is the only potentially curative treatment for PDAC, but in approximately 80% of symptomatic patients, the tumor is already unresectable at the time of diagnosis. (medscape.com)
Liver tumors1
- Right hepatic angiogram shows early enhancement of multiple liver tumors. (medscape.com)
Desmoid tumors4
- [3] The extracolonic tumors may include osteomas of the skull, thyroid cancer , epidermoid cysts , fibromas , [4] as well as the occurrence of desmoid tumors in approximately 15% of affected individuals. (wikipedia.org)
- Desmoid tumors are fibrous tumors that usually occur in the tissue covering the intestines and may be provoked by surgery to remove the colon. (wikipedia.org)
- Gardner syndrome is also associated with familial adenomatous polyposis and may manifest as aggressive fibromatosis (desmoid tumors) of the retroperitoneum. (wikipedia.org)
- Desmoid tumors arise most frequently from the aponeurosis of the rectus abdominal muscle of multiparous women. (wikipedia.org)
Perihilar tumors3
- Perihilar tumors are the most common CCCs, and intrahepatic tumors are the least common. (medscape.com)
- Note 2:** According to TNM, perihilar tumors are defined as those located in the extrahepatic biliary tree proximal to the origin of the cystic duct. (cancer.gov)
- However, as a general rule, true resectability is ultimately determined at surgery, particularly with perihilar tumors. (gastrotraining.com)
Ductal2
- The two primary clinical phenotypes are within the liver, or intrahepatic, large ductal tumors and mass-forming tumors. (marijuanadoctors.com)
- Biliary ductal dilatation is easily demonstrated with US, but the tumor mass is seldom localized with it. (medscape.com)
Cholangiocarcinomas4
- Cholangiocarcinomas are a distinct set of tumors speculated to develop in the biliary tract epithelium within the biliary tract or the liver. (marijuanadoctors.com)
- These tumors are also known as intrahepatic cholangiocarcinomas. (tri-kobe.org)
- Tumors of this region are also known as perihilar cholangiocarcinomas or Klatskin tumors. (tri-kobe.org)
- Tumors of this region are also known as extrahepatic cholangiocarcinomas (Figure 2 ). (tri-kobe.org)
Carcinomas2
- Carcinoid tumors and small-cell carcinomas of the gallbladder and extrahepatic bile ducts: a comparative study based on 221 cases from the Surveillance, Epidemiology, and End Results Program. (cancercentrum.se)
- Solitary well-demarcated tumors are difficult to differentiate from primary hepatocellular carcinomas (HCCs). (medscape.com)
Neuroendocrine tumor1
- Two individuals (0.9%) in the FPC cohort had a pancreatic tumor, including one advanced PDAC and one early grade 2 neuroendocrine tumor. (medscape.com)
Ducts5
- Ultrasonography always detects dilatation of the bile ducts, but more rarely the tumor itself.Magnetic resonance cholangiopancreatography (MRCP) is a good non-invasive alternative to these other procedure. (wikipedia.org)
- Tumors of the intrahepatic bile ducts originate in small intrahepatic ductules or large intrahepatic ducts that are proximal to the bifurcation of the right and left hepatic ducts. (tri-kobe.org)
- Note 1:** For cases coded to primary site code C240 (extrahepatic bile ducts), code the subsite in which the tumor arose. (cancer.gov)
- Tumors located at the confluence of the right and left hepatic ducts with the proximal common hepatic duct are called Klatskin tumors. (medscape.com)
- For this reason, it is not unusual for a pathologist to see BiIN inside the bile ducts surrounding the tumour. (mypathologyreport.ca)
Carcinoid6
- Gastrointestinal carcinoid, also called carcinoid tumor , is the most common primary tumor of the small bowel and appendix. (medscape.com)
- Carcinoid tumors are of neuroendocrine origin and derived from primitive stem cells in the gut wall, especially the appendix. (medscape.com)
- Although carcinoid tumors have a tendency to grow slowly, they do have the potential for metastasis.Carcinoid tumors are divided into well-differentiated (ie, low grade and intermediate grade) and poorly differentiated (ie, high grade). (medscape.com)
- One classification of carcinoid tumors is based on location from which the tumor cells arise and the vascular supply: foregut, midgut, hindgut. (medscape.com)
- Most patients with carcinoid syndrome have liver metastases from a bowel carcinoid, although in rare cases, the humoral load from a primary tumor may overwhelm the liver and the capacity of the lungs to metabolize serotonin. (medscape.com)
- A carcinoid is a functioning tumor, which means that clinical correlation is important. (medscape.com)
Classification1
- Classification is based on the extent of the tumor: local, regional, and distant spread. (medscape.com)
Gallbladder cancer1
- [ 1 ] In contrast, bile duct tumors located outside of the liver had been classified with gallbladder cancer as extrahepatic biliary tract tumors. (tri-kobe.org)
Biliary tract2
- citation needed] Approximately 15,000 new cases of liver and biliary tract carcinoma are diagnosed annually in the United States, with roughly 10% of these cases being Klatskin tumors. (wikipedia.org)
- Peroral cholangioscopy using the SpyGlass system provides effective and safe direct visualization of the biliary tract , as well as biopsy for morphological verification and prescription of chemotherapy in patients with intraductal growth of tumor . (bvsalud.org)
Resectability2
- However, patients that are candidates for resectability are few and moreover many of these patients will have a relapse despite apparent removal of the tumor. (wikipedia.org)
- Improvement in the resectability of tumors requires detection of PDAC at an earlier stage. (medscape.com)
Arise2
- The tumors arise from enterochromaffin cells of Kulchitsky, which are considered neural crest cells situated at the base of the crypts of Lieberkuhn. (medscape.com)
- Bile duct tumors that involve the common hepatic duct bifurcation are referred to as Klatskin tumors regardless of whether they arise from the intrahepatic or extrahepatic portion of the biliary tree. (gastrotraining.com)
Hepatic duct1
- Klatskin G. Adenocarcinoma of the hepatic duct at its bifurcation within the porta hepatis. (medscape.com)
Adenocarcinoma1
- Gastric Extent of Tumor Predicts Peritoneal Metastasis in Siewert II Adenocarcinoma. (viictr.org)
Malignancy2
- EUS-guided fine-needle aspiration has a greater sensitivity for detecting malignancy than ERCP with brush cytology but has the potential for tumor seeding. (medscape.com)
- CT may demonstrate the tumor if the malignancy is nodular and masslike, but tumors of the diffuse sclerosing variety are difficult to detect. (medscape.com)
Obstruction1
- Gallbladder and bile duct tumors can cause extrahepatic biliary obstruction. (merckmanuals.com)
Endoscopic4
- Endoscopic treatment of obstructive jaundice in patients with Klatskin tumor]. (bvsalud.org)
- To improve treatment outcomes in patients with Klatskin tumor and obstructive jaundice by using of endoscopic bilioduodenal stenting. (bvsalud.org)
- Endoscopic bilioduodenal stenting was performed in 250 patients including 25 (10%) ones with Klatskin tumor . (bvsalud.org)
- Compared with the other techniques, endoscopic retrograde cholangiopancreatography (ERCP) is a more definitive investigation that can depict the periampullary tumor. (medscape.com)
Stents3
- 5 (20%) patients with Klatskin tumor type II received self -expanding stents . (bvsalud.org)
- Two 2 (8%) patients with Klatskin tumor type IV underwent bilateral bilioduodenal stenting with plastic and bifurcation self -expanding stents . (bvsalud.org)
- After close to a month of tests and surgery for stents we were told that she had a "Klatkins tumor" which we later found out was not the case and that she was inoperable. (cholangiocarcinoma.org)
Radiotherapy1
- A biliary catheter (red tube) runs through the tumor volume and was used to deliver brachytherapy, which was given in addition to external-beam radiotherapy. (medscape.com)
Gastrointestinal tract1
- [ 1 ] Most tumors of the gastrointestinal tract are located in the small bowel. (medscape.com)
Papillary1
- The papillary tumors are friable and vascular and tend to bleed easily, causing hemobilia. (medscape.com)
Symptomatic1
- Because of their location, these tumors tend to become symptomatic late in their development and therefore are not usually resectable at the time of presentation. (wikipedia.org)
Patients6
- Klatskin tumor is a type of bile duct cancer that often occurs in patients above age 60-70 years old presenting with yellowing of the eyes (jaundice) and skin itchiness. (iswantosucandyliversurgery.com)
- In case of tumor type IIIA, 3 (12%) patients underwent stenting of the right lobar duct with plastic stent . (bvsalud.org)
- Four (16%) patients with Klatskin tumor type III B underwent stenting of the left lobar duct. (bvsalud.org)
- Bilioduodenal stenting as minimally invasive and physiological method was highly effective for obstructive jaundice in patients with Klatskin tumor . (bvsalud.org)
- In most patients, the tumor cannot be completely removed by surgery and is incurable. (tri-kobe.org)
- Patients with one remaining kidney in which tumor is present. (cedars-sinai.org)
Surgical resection1
- The main treatment of Klatskin tumor and any bile duct cancer is complete surgical resection to remove the cancer and its associated surrounding lymphnodes. (iswantosucandyliversurgery.com)
Squamous1
- More than 90% are adenocarcinomas, and the remainder are squamous cell tumors . (medscape.com)
Solitary1
- If there is only one tumour, it will be described in your report as solitary. (mypathologyreport.ca)
Surgery2
- The type of surgery and the extent of the resection depend on the location of the tumor and the degree of extension. (wikipedia.org)
- However, because of a steep learning curve, a formal structure of minimally invasive liver surgery training and application might be of particular importance for surgeons working in specialized liver tumor centers. (fortunejournals.com)
MRCP2
- However, with the advent of magnetic resonance cholangiopancreatography (MRCP), easy demonstration of stricture-causing tumors is possible. (medscape.com)
- The disadvantages of MRCP are its inability to distend the duct and the equivocal findings due to long segments and minimal narrowing in diffuse sclerosing tumors. (medscape.com)
Structures3
- Such technology has assisted greatly in the delivery of high doses to the tumor, while sparing vital normal structures, such as the kidney and spinal cord. (medscape.com)
- This finding is characterized by an expanded matrix production with the remodeling of connective tissue structures within a tumor, not unlike chronic-active scarring. (picmonic.com)
- The grade is based on the percentage of the tumour forming round gland-like structures. (mypathologyreport.ca)
Polyps1
- Gardner syndrome is an autosomal dominant form of polyposis characterized by the presence of multiple polyps in the colon together with tumors outside the colon. (wikipedia.org)
Outcomes1
- In his recent publication, he concluded that robotic Klatskin tumor resection is safe, feasible and reproducible with excellent outcomes. (iswantosucandyliversurgery.com)
Clinical1
- An unusual tumor with distinctive clinical and pathological features. (medscape.com)
Diagnosis1
- Due to the small size of the tumor, the diagnosis is often late (not visible by the regular CT scans or Ultrasonography imaging). (iswantosucandyliversurgery.com)
Type1
- The most common type is extrahepatic, and the least common type is the intrahepatic tumor. (picmonic.com)
Preoperative1
- Adjuvant and preoperative radiation therapy has been used to reduce tumors in an effort to make them resectable. (medscape.com)
Detect1
- Since your bile duct is situated deep inside your body, doctors can't easily detect tumors during routine physical examinations. (marijuanadoctors.com)
Radiation therapy1
- Tumor ablation may also be used in combination with radiation therapy. (cedars-sinai.org)