Nezhoubné nádory a pseudotumory v porta hepatis maskující perihilární cholangiokarcinom

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Autoři: K. Vasiliadis ¹; O. Ioannidis ²; K. Tsalis ²
Působiště autorů: 1st Surgical Department, General Hospital Papageorgiou, Thessaloniki, Greece ¹; 4th Surgical Department, Medical School, Aristotle University of Thessaloniki, General Hospital George Papanikolaou, Thessaloniki, Greece ²
Vyšlo v časopise: Klin Onkol 2019; 32(6): 411-425
Kategorie: review
doi: https://doi.org/10.14735/amko2019411

Souhrn

Východiska: Hilární cholangiokarcinom (HC) nazývaný také Klatskinův tumor je letální primární extrahepatální karcinom z biliárního epitelu vznikající do 2 cm od spojení žlučovodů. Nejlepší šanci na vyléčení představuje radikální chirurgická excize. Léčba pacientů s HC je však problematická, a to z důvodu vysokých požadavků na zkušenosti s biliárními a jaterními resekcemi a také proto, že stanovení přesné diagnózy před operací není jednoduché. Diferenciální diagnostika HC představuje diagnostické dilema, neboť ani moderní, sofistikované diagnostické modality neposkytnou vždy definitivní preoperativní diagnózu. Stavy, které mohou HC mimikovat, jsou navíc přítomné až u 25 % pacientů s obstrukcí žlučových cest. Proto je precizní stanovení etiologie zúžení hilu před operací zásadní, aby se předešlo zbytečným, vysoce rizikovým závažným chirurgickým zákrokům. Benigní stavy vydávající se za Klatskinův tumor si v diferenciální diagnostice obstrukce hilu zaslouží své místo. Cíl: Vzhledem k důležitým klinickým implikacím přesné diagnózy etiologie obstrukce žlučových cest v jaterním hilu se tento článek zaměřuje na rozlišení HC a benigních obstrukcí hilu. Bude uveden přehled benigních nádorů a pseudotumorů vydávajících se za HC společně s jejich charakteristickými diagnostickými znaky.

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Obdrženo: 4. 2. 2019

Přijato: 4. 9. 2019

Klíčová slova:

Klatskinův tumor – hilární biliární striktura – nesprávná diagnóza – benigní Klatskinovy léze – léze podobné Klatskinovým lézím

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