Metastatic Prostatic Carcinoma Presenting as Cholangiocarcinoma ("Klatskin Tumor")

To the Editor:The clinical picture of prostatic cancer is sometimes puzzling, partly because of the marked variation in the pattern of dissemination (1). We report a case of metastatic prostatic adenocarcinoma manifesting clinically as a Klatskin tumor. In April 1989, a 77-year-old previously healthy black man presented with a 4-day history of yellow scleral discoloration and passage of dark-colored urine and clay-colored stool. No recurrent abdominal pain, itchy skin, or weight loss was noted. Except for icterus and asymptomatic prostatic enlargement without nodules, the examination was unremarkable. The total bilirubin level was 8.7 mg/dL, with a conjugated bilirubin level...