Ovarian metastasis from Klatskin tumour

Hilar cholangiocarcinoma, a rare bile duct malignancy, typically metastasises to the liver, lungs or lymph nodes, with ovarian involvement being exceedingly rare. We present a case of a South Asian woman in her mid-30s with abdominal pain, constipation, right upper quadrant discomfort and fever. Imaging and histopathological analysis of biopsy confirmed a hilar mass with ovarian metastasis, supported by elevated CA 19-9 levels. Palliative biliary stenting was performed, but the patient succumbed 6 months postdiagnosis. This case highlights the importance of recognising atypical metastatic patterns in hilar cholangiocarcinoma to guide diagnostic and therapeutic strategies.