Introduction Very rare Adenocarcinoma is most common primary tumor. Epidemiology occurs late in life. gallstones are a risk factor more common in far east associated with chronic Salmonella typhi infection Klatskin's tumor occurs at junction of hepatic ducts and CBD lethal with mean survival of 9-12 mos Presentation Persistent biliary colic. Evaluation Ultrasound Radiography/CT can demonstrate a porcelain gallbladder (specific sign) Treatment Palliative stenting of bile ducts. Surgical resection for palliation only. Prognosis, Prevention, and Comlications Almost all patient dead within one year.