Multimodality Evaluation of Klatskin Tumor: Detection by SPECT Alone

A 35-year-old woman presented with obstructive jaundice. Abdominal ultrasound showed biliary dilatation but could not define the cause. Abdominal CT imaging revealed extensive intra- and extrahepatic biliary tree dilatation but did not conclusively demonstrate the cause. On a subsequent technetlum-99m sulfur colloid image, planar images reveaied a possible lesion in the left hepatic lobe; SPECT images confirmed the presence of the mass. Surgical exploration later determined the tumor to be an unresectable adenocarcinoma of the common bile duct (also known as Klatskin tumor).