Free Essays, Term Papers, Research Papers at Anti Essays

Klatskin tumor

Hilar biliary malignancy refers to any neoplastic biliary obstruction involving the hepatic hilus. clinically, this includes all tumors involving the proximal 2 cm of the common hepatic duct and/or the left and right hepatic ducts and their branches.

The first hilar resection for cholangiocarcinoma was undertaken only 40 years ago and it was only 30 years ago that Klatskin reported a series of 13 patients with resected biliary adenocarcinoma at the hepatic duct confluence. His report was the beginning of a focused approach to these tumors, now commonly referred to as "Klatskin tumors."

Incidence

Cancer of the bile duct, cholangiocarcinoma, is an uncommon malignancy comprising less than 2% of all cancer diagnoses. The overall rate of occurrence of cholangiocarcinoma is 1.2/100,000 individuals, with two-thirds of all cases occuring in patients more than 65 years old, and a near 10-fold increased rate of occurrence in patients more than 80 years of age. Each year, there are approximately 2,500 new cases of hilar cholangicarcinoma and 1,000 cases of distal cholangicarcinom in the United States. Worldwide, cholangiocarcinoma accounts for 3% of all gastrointestinal cancers and is the second commonest primary hepatic tumor. Tumors at the biliary confluence at the hilum of the liver are the most common and comprise 40% to 60% of the total bile duct cancer. A small percentage of patients (<10%) may present with diffuse tumors involving the entire extrahepatic bile duct; and in these cases, operation is almost never curative, and survival is very poor.

Pathogenesis and tumor biology

Although no clear causal agent for cholangiocarcinoma has been identified, certain pathological conditions that result in either acute or chronic biliary epithelial injury appear to predispose to its development. Occult cholangiocarcinoma has been identified in up to 40% of autopsy...