Benign inflammatory pseudotumour of the biliary tract masquerading as a Klatskin tumour

In the presence of obstructive jaundice, irregular strictures high in the common hepatic duct are usually due to bile duct cancer or to metastatic infiltration from other malignant tumours. Postoperative strictures and a variety of benign tumours also occur in this region but usually have a distinctive appearance on retrograde cholangiography. Obstruction of the bile duct due to an impacted calculus in Hartmann's pouch (Mirizzi syndrome) and sclerosing cholangitis also have characteristic radiological appearances and are supported by the coexistence of gallstones and inflammatory bowel disease respectively.

This case report describes a much rarer entity, an inflammatory pseudotumour of the bile duct, which was only diagnosed after histological evaluation of a specimen resected for presumed bile duct cancer.

Clinicians should be aware of the possibility of a benign cause for a cholangiogram showing obstruction due to an apparent Klatskin tumour and of the good long-term outcome of surgical excision of these lesions.