Biliary tract cancers usually occur after the 6th decade of life, with slightly higher prevalence in male patients. Only 25% of these tumours are located in the middle segment of the main biliary tract. Because of the site and biology of this neoplasm, radical surgical treatment is rarely possible. Also the lack of effective additional therapies makes it impossible to improve survival or quality of life in most patients. The authors present a case of a 70-year-old male patient with primary cancer of the middle segment of the biliary tract, in whom radical local excision was performed.