The aims of this exhibit are first to review the morphological and anatomical classifications of cholangiocarcinoma,
second to emphasize the role of computed tomography and resonance magnetic imaging in the diagnosis,
staging and resectability evaluation of cholangiocarcinoma,
and third to clarify the goals and indications of percutaneous transhepatic biliary drainage including biliary stenting in the management of locally advanced and metastatic cholangiocarcinoma.
Cholangiocarcinoma (CC) is a malignant primary tumor that originates in the epithelium of the biliary ducts,
and that poses a diagnostic and therapeutic challenge owing to the broad range of histologic types,
and clinical manifestations,
along with varying imaging manifestations that can overlap those of other hepatobiliary diseases.
It is the second most frequent hepatobiliary tumor after hepatocellular carcinoma,
diagnosed usually in patients above 65 years of age with a slight prevalence in men,
and is predominantly adenocarcinoma (95% of cases) at histologic...
Findings and procedure details
Cholangiocarcinomas may occur at any segment of the bile duct from the terminal ductules to the ampulla of Vater.
they can be classified anatomically as intrahepatic or peripheral (6- 8% of cases),
perihilar also called Klatskin tumors (50- 67% of cases),
and extrahepatic (27- 42%) ( Fig. 1 ).
The reference point to differentiate intrahepatic from perihilar CC is the second order bile ducts.
Intrahepatic cholangiocarcinomas arise from beyond second-order bile ducts. Tumors originating in the right,
left or common hepatic conduits...
The optimal approach to the management of cholangiocarcinomas involves accurate diagnosis,
localization and staging,
and evaluation of adjacent structures,
followed by the assessment of tumor resectability and candidacy for surgical intervention or palliative therapies.
Radiologic spectrum of cholangiocarcinoma: emphasis on unusual manifestations and differential diagnoses.
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