Iwaniec-Karlikowska Edyta, Augustyn Monika, Grys Iwon
Department of Internal Medicine and Gastroenterology, 5th Military Hospital in Cracow, Poland.
Pol Merkur Lekarski. 2016 Feb;40(236):107-9.
Cholangiocarcinoma (CCA) is the second most frequent liver malignancy, responsible for 10-15% primary liver cancers. This tumor is difficult to diagnose and characterized by high mortality rate. Extrahepatic CCA is a specific type known as Klatskin tumor.
The patient was admitted to the Clinic of Internal Medicine and Gastroenterology with intrahepatic cholestasis. Imaging revealed Bismuth type IV hilum tumor. Due to rare occurrence of this malignancy the patient was directed to the tertiary center. During surgical exploration radical treatment was abandoned as a result of tumor's advanced stadium. Histology evaluation revealed infiltrating adenocarcinoma. ERCP and biliary duct stenting was performed. The patient was qualified for paliative chemotherapy according to gemcytabine+cisplatine protocol (d1, d15 every 28 days). Posttreatment follow-up revealed total remission of the tumor.
胆管癌（CCA）是第二常见的肝脏恶性肿瘤，占原发性肝癌的10 - 15%。这种肿瘤难以诊断，死亡率高。肝外CCA是一种特殊类型，称为Klatskin瘤。
患者因肝内胆汁淤积入住内科和胃肠病学诊所。影像学检查显示为IV型肝门部肿瘤。由于这种恶性肿瘤罕见，患者被转诊至三级中心。手术探查时，由于肿瘤处于晚期，放弃了根治性治疗。组织学评估显示为浸润性腺癌。进行了内镜逆行胰胆管造影（ERCP）和胆管支架置入术。患者按照吉西他滨+顺铂方案（每28天的第1天和第15天）接受姑息化疗。治疗后随访显示肿瘤完全缓解。
