Tumors of the Biliary Tract

Biliary tract tumors are derived from the underlying intrahepatic or extrahepatic biliary epithelium. Molecular analysis of the biliary neoplasms suggests a stepwise tumor progression from benign to malignant lesions. Treatment of these tumors remains complex and requires a careful clinical evaluation. Revisions of staging systems allow for appropriate evaluation of the extent of the malignancy. Refined surgical techniques and advances in adjuvant therapies provide improved treatment options. Despite these efforts, the prognosis remains poor. This chapter discusses several different types of biliary tumors, including the gallbladder carcinoma, and examines the underlying etiologies, clinical presentation, diagnostic studies, staging, treatment, and prognosis. The staging of the malignant lesions is updated to reflect the American Joint Committee on Cancer’s eighth edition system. This review contains 7 figures, 5 tables, and 77 references. Key Words: α-fetoprotein, American Joint Committee on Cancer, biliary intraepithelial neoplasia, Bismuth-Corlette, CA19-9, cystadenoma, endoscopic retrograde cholangiopancreatography, intraductal papillary neoplasm of the bile duct, Magnetic resonance cholangiopancreatography, primary sclerosing cholangitis, percutaneous transhepatic cholangiography