Maligne Gallengangtumoren: Diagnostik und therapeutische Grundlagen

Plötzlich gelb! Der Ikterus ist meist ein spätes Zeichen für den primären Leberkrebs der Gallengänge. Die Differenzialdiagnosen sind vielseitig. Klinik, Laborparameter und der Ultraschall helfen, eine Cholestase und Konkremente zu identifizieren – eine weiterführende Diagnostik ist dann die Domäne der Schnittbildgebung und insbesondere der MRT und der MRCP [1].

Schlüsselwörter

Gallengangkarzinom - Cholangiokarzinom - Klatskin-Tumor - Bismuth-Corlette - Gallenblasentumor

Key words

bile duct cancer - cholangiocarcinoma - Klatskin tumor - gallbladder cancer

• Literatur

• 1 S3-Leitlinie Diagnostik und Therapie des Hepatozellulären Karzinoms und biliärer Karzinome. Im Internet (Stand: 24.09.2022): https://www.leitlinienprogramm-onkologie.de/fileadmin/user_upload/LL_Hepatozellul%25C3%25A4res_Karzinom_und_bili%25C3%25A4re_Karzinome_Langversion_3.0.pdf
• 2 Sinn M, Arnold D, Borner M. et al. Leitlinie Biliäre Karzinome Onkopedia. Im Internet (Stand: 24.09.2022): http://www.onkopedia.com/de/onkopedia/guidelines/biliaere-karzinome/@@guideline/html/index.html
• 3 Fischbach F, Fischbach K. MRT der Leber. 1. Aufl.. Stuttgart: Thieme; 2016
• 4 Lazaridis KN, Gores GJ. Cholangiocarcinoma. Gastroenterology 2005; 128: 1655-1667
• 5 Gouma DJ, Obertop H, Vismans J. et al. Progression of a benign epithelial ampullary tumor to adenocarcinoma. Surgery 1987; 101: 501-504
• 6 Chung YE, Kim MJ, Park YN. et al. Varying appearances of cholangiocarcinoma: radiologic-pathologic correlation. Radiographics 2009; 29: 683-700
• 7 Lee WJ, Lim HK, Jang KM. et al. Radiologic spectrum of cholangiocarcinoma: emphasis on unusual manifestations and differential diagnoses. Radiographics 2001; 21: 97-116
• 8 Sempoux C, Jibara G, Ward SC. et al. Intrahepatic cholangiocarcinoma: new insights in pathology. Semin Liver Dis 2011; 31: 49-60
• 9 Zen Y, Adsay NV, Bardadin K. et al. Biliary intraepithelial neoplasia: an international interobserver agreement study and proposal for diagnostic criteria. Mod Pathol 2007; 20: 701-709
• 10 Lim JH, Yoon KH, Kim SH. et al. Intraductal papillary mucinous tumor of the bile ducts. Radiographics 2004; 24: 53-66
• 11 Chatterjee A, Lopes Vendrami C, Nikolaidis P. et al. Uncommon Intraluminal Tumors of the Gallbladder and Biliary Tract: Spectrum of Imaging Appearances. Radiographics 2019; 39: 388-412
• 12 Ronnekleiv-Kelly SM, Pawlik TM. Staging of intrahepatic cholangiocarcinoma. Hepatobiliary Surg Nutr 2017; 6: 35-43
• 13 Valle JW, Borbath I, Khan SA. et al. Biliary cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2016; 27: 28-37
• 14 Hwang J, Kim YK, Park MJ. et al. Differentiating combined hepatocellular and cholangiocarcinoma from mass-forming intrahepatic cholangiocarcinoma using gadoxetic acid-enhanced MRI. J Magn Reson Imaging 2012; 36: 881-889
• 15 Jeong HT, Kim MJ, Chung YE. et al. Gadoxetate disodium-enhanced MRI of mass-forming intrahepatic cholangiocarcinomas: imaging-histologic correlation. Am J Roentgenol 2013; 201: 603-611
• 16 Kim SJ, Lee JM, Han JK. et al. Peripheral mass-forming cholangiocarcinoma in cirrhotic liver. Am J Roentgenol 2007; 189: 1428-1434
• 17 Péporté AR, Sommer WH, Nikolaou K. et al. Imaging features of intrahepatic cholangiocarcinoma in Gd-EOB-DTPA-enhanced MRI. Eur J Radiol 2013; 82: 101-116
• 18 Kurogi M, Nakashima O, Miyaaki H. et al. Clinicopathological study of scirrhous hepatocellular carcinoma. J Gastroenterol Hepatol 2006; 21: 1470-1477
• 19 Soares KC, Arnaoutakis DJ, Kamel I. et al. Cystic neoplasms of the liver: biliary cystadenoma and cystadenocarcinoma. Am Coll Surg 2014; 218: 119-128
• 20 Hann LE, Getrajdman GI, Brown KT. et al. Hepatic lobar atrophy: association with ipsilateral portal vein obstruction. AJR Am J Roentgenol 1996; 167: 1017-1021
• 21 Katabathina VS, Dasyam AK, Dasyam N. et al. Adult bile duct strictures: role of MR imaging and MR cholangiopancreatography in characterization. Radiographics 2014; 34: 565-586
• 22 Kim TU, Kim S, Lee JW. et al. Ampulla of Vater: comprehensive anatomy, MR imaging of pathologic conditions, and correlation with endoscopy. Eur J Radiol 2008; 66: 48-64
• 23 Alessandrino F, Ivanovic AM, Yee EU. et al. MDCT and MRI of the ampulla of Vater. Part I: technique optimization, normal anatomy, and epithelial neoplasms. Abdom Imaging 2015; 40: 3274-3291
• 24 Yu MH, Kim YJ, Park HS. et al. Benign gallbladder diseases: Imaging techniques and tips for differentiating with malignant gallbladder diseases. World J Gastroenterol 2020; 26: 2967-2986
• 25 Catalano OA, Sahani DV, Kalva SP. et al. MR imaging of the gallbladder: a pictorial essay. Radiographics 2008; 28: 135-155