{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T15:47:11Z","timestamp":1776440831447,"version":"3.51.2"},"reference-count":70,"publisher":"Walter de Gruyter GmbH","issue":"2","license":[{"start":{"date-parts":[[2018,5,25]],"date-time":"2018-05-25T00:00:00Z","timestamp":1527206400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,25]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"j_iss-2018-0010_s_999_w2aab3b7c51b1b6b1aab1c16b1Aa\"><jats:title>Background:<\/jats:title><jats:p>Even though IgG4-related disease has gained increased attention worldwide, the diagnosis remains challenging. IgG4-related sclerosing cholangitis (IgG4-SC) is not well described in the western hemisphere and may mimic cholangiocarcinoma (CC), especially when occurring without other symptoms such as, e.g. concurrent pancreatitis or retroperitoneal fibrosis. We present a case to add further information to the diagnosis and treatment of this challenging disease.<\/jats:p><\/jats:sec><jats:sec id=\"j_iss-2018-0010_s_998_w2aab3b7c51b1b6b1aab1c16b2Aa\"><jats:title>Case report:<\/jats:title><jats:p>A 60-year-old male patient presented with painless jaundice. Prior medical history showed diabetes mellitus type I, high blood pressure, and deep vein thrombosis. Diagnostic investigations were strongly suspicious of a Klatskin tumor, although biopsies were inconclusive. The tumor marker Carbohydrate Antigen 19-9 (CA 19-9) was elevated. Prior to the recommended surgery, the patient had two second opinions in two different university hospitals, both arguing for surgery as well. The patient received hilar resection with right hemihepatectomy. During the postoperative course, some major complications occurred, i.e. recurrent pleural effusion, abscess in the liver resection area, sepsis, ileus, and restricted liver metabolism. Treatment with prednisolone did not show any improvement. Approximately 3 months after surgery, the patient died in consequence of acute respiratory failure. Histology showed no signs of CC, but IgG4-SC could be diagnosed.<\/jats:p><\/jats:sec><jats:sec id=\"j_iss-2018-0010_s_997_w2aab3b7c51b1b6b1aab1c16b3Aa\"><jats:title>Conclusion:<\/jats:title><jats:p>In the case of preoperative signs of CC, differential diagnosis of IgG4-SC needs to be considered, in particular, in cases with missing histologic proof of malignant disease.<\/jats:p><\/jats:sec>","DOI":"10.1515\/iss-2018-0010","type":"journal-article","created":{"date-parts":[[2018,5,25]],"date-time":"2018-05-25T09:20:27Z","timestamp":1527240027000},"page":"157-163","source":"Crossref","is-referenced-by-count":3,"title":["IgG4-related sclerosing cholangitis mimicking hilar cholangiocarcinoma (Klatskin tumor): a case report of a challenging disease and review of the literature"],"prefix":"10.1515","volume":"3","author":[{"given":"Anke","family":"Mittelstaedt","sequence":"first","affiliation":[{"name":"Clinic for General and Digestive Surgery, Center for Endocrine, Oncologic and Metabolic Surgery, DIAKOVERE Henriettenstift, Marienstra\u00dfe 72-90, D-30171 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter N.","family":"Meier","sequence":"additional","affiliation":[{"name":"Clinic for Gastroenterology, DIAKOVERE Henriettenstift, Marienstra\u00dfe 72-90, D-30171 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Dankoweit-Timpe","sequence":"additional","affiliation":[{"name":"Institute for Pathology, Nienburger Stra\u00dfe 12, 30167 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beate","family":"Christ","sequence":"additional","affiliation":[{"name":"Clinic for Diagnostic and Interventional Radiology, DIAKOVERE Henriettenstift, Marienstra\u00dfe 72-90, D-30171 Hannover, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"Jaehne","sequence":"additional","affiliation":[{"name":"Clinic for General and Digestive 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