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BILIARY TRACT CANCER
Gallbladder cancer is frequently asymptomatic until late in the course. When the tumor does present, it may be with cholecystitis, enlarged palpable gallbladder, or biliary tract obstruction (uncommon). X-ray may show a calcified “porcelain gallbladder.” Microscopically, the tissues show adenocarcinoma. The prognosis for gallbladder cancer is poor; 5-year survival rate is ~12%.
Bile duct cancer. Bile duct carcinoma is carcinoma of the extrahepatic bile ducts, while cholangiocarcinoma is carcinoma of the intrahepatic bile ducts. Klatskin tumor is a carcinoma of the bifurcation of the right and left hepatic bile ducts. Risk factors for bile duct cancer include Clonorchis (Opisthorchis) sinensis (liver fluke) in Asia and primary sclerosing cholangitis. Bile duct cancer typically presents with biliary tract obstruction. Microscopic examination shows adenocarcinoma arising from the bile duct epithelium. The prognosis is poor.
Adenocarcinoma of the ampulla of Vater may exhibit duodenal, biliary, or pancreatic epithelium. Patients present with painless jaundice. The 5-year survival rate is <50% in spite of resection.
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