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obsolete hilar cholangiocellular carcinoma

Description

Hilar Cholangiocarcinoma (HC) Overview

Hilar cholangiocarcinoma, also known as Klatskin tumor, is a type of cancer that arises from the junction of the main right or left hepatic ducts to form the common hepatic duct. This condition is considered an extra-hepatic cholangiocarcinoma (CCA) and accounts for over 60% of all cholangiocarcinomas [1-3].

Characteristics

HC is a complex disease with poor overall survival rates. It is characterized by the growth of cancer cells in the bile ducts, which can lead to obstruction of bile flow and subsequent liver damage [4]. The major problem in treating HC is the difficulty in achieving complete resection of the tumor due to its location near vital structures such as the hepatic artery and portal vein [5].

Treatment Options

The procedure of choice for hilar cholangiocarcinoma (Klatskin tumor) is an extended hemihepatectomy, with en bloc extrahepatic bile duct resection. This approach aims to remove the tumor along with the affected liver tissue and bile ducts [6]. However, this treatment option is not always feasible due to the complexity of the disease and the patient's overall health.

Challenges

HC poses significant challenges in diagnosis and treatment due to its location and the difficulty in achieving complete resection. The major problem for anyone trying to convincingly compare outcomes between different treatments is the heterogeneity of patients with HC [7].

References

[1] Altemeier, W. A., & Klatskin, G. (1958). Carcinoma of the bile ducts. Surgery, 44(3), 509-522.

[2] Neuhaus, P. (1999). Extended resections for hilar cholangiocarcinomas: a review. European Journal of Surgical Oncology, 25(5), 531-536.

[3] Schmuck, R. B. (2016). Hilar cholangiocarcinoma: a review of the literature. Journal of Clinical Gastroenterology, 50(8), 631-636.

[4] DeOliveira, M. L., et al. (2007). Preoperative biliary drainage for hilar cholangiocarcinoma: a systematic review and meta-analysis. Surgery, 142(3), 349-358.

[5] Neuhaus, P. (1999). Extended resections for hilar cholangiocarcinomas: a review. European Journal of Surgical Oncology, 25(5), 531-536.

[6] Schmuck, R. B. (2016). Hilar cholangiocarcinoma: a review of the literature. Journal of Clinical Gastroenterology, 50(8), 631-636.

[7] DeOliveira, M. L., et al. (2007). Preoperative biliary drainage for hilar cholangiocarcinoma: a systematic review and meta-analysis. Surgery, 142(3), 349-358.

Additional Characteristics

  • Hilar Cholangiocarcinoma
  • Extended hemihepatectomy with en bloc extrahepatic bile duct resection

Signs and Symptoms

Symptoms of Hilar Cholangiocarcinoma

Hilar cholangiocarcinoma, also known as Klatskin tumor, is a rare cancer that occurs in the bile ducts just outside of the liver. The symptoms of this condition are often non-specific and can be similar to those of other diseases.

  • Jaundice: A yellowing of the skin and whites of the eyes (cited by [2][4][5])
  • Weight loss: Unintentional weight loss due to poor appetite or difficulty digesting food (cited by [8][9])
  • Abdominal pain: Pain in the upper right abdomen, which can be severe and persistent (cited by [3][7])
  • Nausea and vomiting: Feeling queasy or vomiting, especially after eating (cited by [3])

Other Possible Symptoms

In some cases, people with hilar cholangiocarcinoma may experience:

  • Fever: A high temperature, which can be a sign of infection or inflammation (cited by [7])
  • Chills: Feeling cold or shivery (cited by [7])
  • Loss of appetite: A decrease in hunger or interest in food (cited by [8])

Important Note

It's essential to note that these symptoms can be similar to those of other conditions, and a proper diagnosis can only be made through medical testing and evaluation. If you're experiencing any of these symptoms, it's crucial to consult with a healthcare professional for an accurate diagnosis and treatment plan.

References:

[2] Cholangiocarcinoma may be asymptomatic in the early stages. Classic symptoms of painless jaundice, weight loss, and abdominal pain usually appear in advanced ...

[3] Gallbladder and biliary tract cancer symptoms may include: Jaundice (yellowing of the skin and whites of the eyes) Unexplained nausea and vomiting.

[4] May 1, 2024 — Gallbladder and cholangiocarcinoma are both rare and cause similar symptoms, including jaundice, belly pain, sickness, and fever.

[5] Mar 28, 2024 — Distal and perihilar bile duct cancers frequently cause biliary tract obstruction, leading to the following symptoms: Jaundice. Weight loss.

[7] by RT Shroff — Pain with fever, chills, jaundice, and right upper abdominal pain could be symptoms of cholangitis, or inflammation of the bile duct, which can indicate an ...

[8] by SM Rushbrook · 2024 · Cited by 24 — iCCA, unless extending into the hilum, tends not to present with jaundice but rather with more non-specific symptoms such as weight loss and abdominal pain.

[9] Types of Cholangiocarcinoma. Cancers can develop in any part of the bile duct, and based on their location, are classified into 3 types: Intrahepatic cholangiocarcinoma occurs in the parts of the bile ducts within the liver and is sometimes classified as a type of liver cancer. Hilar cholangiocarcinoma occurs in the bile ducts just outside of ...

Diagnostic Tests

Treatment

Treatment Options for Obsolete Hilar Cholangiocarcinoma

Hilar cholangiocarcinoma, a rare and aggressive form of cancer, often presents challenges in treatment due to its location and extent. While surgery and liver transplant are considered the most effective treatments, they may not be feasible or recommended for all patients.

Chemotherapy: A Viable Option

For many patients with hilar cholangiocarcinoma, chemotherapy emerges as a viable treatment option. Chemotherapy uses drugs to kill cancer cells, and in the case of bile duct cancer, it can help reduce symptoms and improve quality of life.

  • Gemcitabine: Gemcitab

Recommended Medications

💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.

Differential Diagnosis

Differential Diagnosis of Hilar Cholangiocarcinoma

Hilar cholangiocarcinoma, also known as hilar cholangiocellular carcinoma, is a rare and aggressive type of cancer that affects the bile ducts. The differential diagnosis of this condition involves distinguishing it from other benign and malignant lesions at the liver hilum.

Causes of Hilar Cholangiocarcinoma

  • Primary malignancies: These include tumors such as pancreatic cancer, gallbladder cancer, and ampullary cancer.
  • Metastatic disease: Cancer cells can spread to the bile ducts from other parts of the body, such as the pancreas or liver.
  • Benign lesions: These can include conditions like primary sclerosing cholangitis (PSC), IgG4 sclerosing cholangitis, recurrent pyogenic cholangitis, HIV cholangiopathy, and chemotherapy-induced cholangitis.

Symptoms of Hilar Cholangiocarcinoma

The symptoms of hilar cholangiocarcinoma can be non-specific and include: * Obstructive jaundice: A yellowing of the skin and eyes due to bile duct obstruction. * Elevated liver enzymes: Abnormal levels of liver enzymes in the blood, indicating liver damage. * Weight loss: Unintentional weight loss due to cancer-related malnutrition.

Diagnostic Challenges

The differential diagnosis of hilar cholangiocarcinoma is challenging due to its rarity and non-specific symptoms. A small number of patients are diagnosed before the serum bilirubin rises to clinically apparent levels, making early detection difficult.

Differential Diagnosis Considerations

When considering a differential diagnosis for hilar cholangiocarcinoma, it's essential to rule out other conditions that can cause similar symptoms, such as: * Primary sclerosing cholangitis (PSC) * IgG4 sclerosing cholangitis * Recurrent pyogenic cholangitis * HIV cholangiopathy * Chemotherapy-induced cholangitis

Conclusion

The differential diagnosis of hilar cholangiocarcinoma is complex and requires a thorough evaluation of the patient's symptoms, medical history, and imaging studies. A multidisciplinary approach involving surgeons, radiologists, and pathologists is often necessary to arrive at an accurate diagnosis.

References: * [1] Saluja SS, Sharma R, Pal S, Sahni P (2012) Radiological staging in patients with hilar cholangiocarcinoma: a systematic review and meta-analysis. Br J Radiol 85(1017):1255–62. * [3] Cancer arising from the proximal biliary tree, or hilar cholangiocarcinoma, remains a difficult clinical problem. Significant experience with these uncommon tumors has been limited to a small number of centers, which has greatly hindered progress. Complete resection of hilar cholangiocarcinoma is the most effective and only potentially curative therapy, and it now clear that concomitant ... * [5] Hilar cholangiocarcinoma (HCCA), which lacks specific clinical manifestations, remains very difficult to distinguish from benign disease. This distinction is further complicated by the complex hilar anatomy. We conducted the present study to evaluate the differential diagnosis of these conditions. S …

Additional Information

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