TUMOR DE KLATSKIN PDF

Cause[ edit ] The cause of cholangiocarcinoma has not been defined. A number of pathologic conditions, however, resulting in either acute or chronic biliary tract epithelial injury may predispose to malignant change. These conditions appear to be related to an anomalous pancreatico-biliary duct junction and, perhaps, are related to the reflux of pancreatic secretions into the bile duct. Chronic biliary tract parasitic infection, seen commonly in Southeast Asia due to Clonorchis sinensis and Opisthorchis viverrini , has also been identified as a risk factor.

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Cause Edit The cause of cholangiocarcinoma has not been defined. A number of pathologic conditions, however, resulting in either acute or chronic biliary tract epithelial injury may predispose to malignant change. These conditions appear to be related to an anomalous pancreatico-biliary duct junction and, perhaps, are related to the reflux of pancreatic secretions into the bile duct.

Chronic biliary tract parasitic infection, seen commonly in Southeast Asia due to Clonorchis sinensis and Opisthorchis viverrini , has also been identified as a risk factor. Further, industrial exposure to asbestos and nitrosamines , and the use of the radiologic contrast agent, Thorotrast thorium dioxide , are considered to be risk factors for the development of cholangiocarcinoma.

Diagnosis Edit Levels of the tumor markers carbohydrate antigen CA , carcinoembryonic antigen CEA and CA are abnormally high in the bloodstreams of patients with intrahepatic cholangiocarcinoma and Klatskin tumor. The serum CA in particular may be very high. At the right, the contrast that has been given before is already well-drained, making the bile ducts clearly recognizable. 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.

Complete resection of the tumor, especially in early-stage disease, offers hope of long-term survival. 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. The type of surgery and the extent of the resection depend on the location of the tumor and the degree of extension. More often, liver resection is not a viable option because many patients are of advanced age, have multiple co-pathologies and are therefore at high risk.

Two-thirds of cases occur in patients over the age of 65, with a near ten-fold increase in patients over 80 years of age. The incidence is similar in both men and women. Annals of Surgical Oncology. Yale Journal of Biology and Medicine. Acta Chirurgica Scandinavica.

Frontiers of Medicine in China. Scandinavian Journal of Gastroenterology. European Journal of Surgical Oncology. A case of our own observation]". Minerva Chirurgica in Italian. Biology and pathology]". Internist Berlin in German. World Journal of Gastroenterology. Ultrasound Quarterly. European Radiology. North Am. Romanian Journal of Internal Medicine. In Vivo. Retrieved Journal of Gastrointestinal Surgery. Seminars in Liver Disease.

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