Cholangiocarcinoma
Key points
- Cholangiocarcinoma is a malignant (cancerous) growth in one of the ducts that carries bile from the liver to the small intestine.
- Malignant tumors of the bile ducts are usually slow-growing and late to spread (metastasize).
- The goal is to treat the cancer and the obstruction it causes.
- The stress of illness can often be eased by joining a support group with members who share common experiences and problems.
Alternative names
Bile duct cancer
Definition
Cholangiocarcinoma is a malignant (cancerous) growth in one of the ducts that carries bile from the liver to the small intestine.
Causes, incidence, and risk factors
Malignant tumors of the bile ducts are usually slow-growing and late to spread (metastasize). Nonetheless, by the time a diagnosis is made, many of these tumors are too advanced to be removed surgically.
A cholangiocarcinoma may arise anywhere along the liver secretion (biliary) ducts. These tumors produce symptoms by blocking the bile ducts. They affect both sexes, and a majority of cases are found in patients above the age of 65.
Primary sclerosing cholangitis, choledochal (bile duct) cysts, and chronic biliary irritation are all associated with increased risk for this condition. Cholangiocarcinoma is rare, occurring in approximately 2 out of 100,000 people.
Symptoms
- Stools, clay colored
- Progressive jaundice
- Itching
- Right upper abdominal pain that may radiate to the back
- Loss of appetite
- Weight loss
- Fever
- Chills
Signs and tests
Tests that show tumor or obstruction in the bile duct:
- ERCP (endoscopic retrograde cholangiopancreatography)
- PTCA (percutaneous transhepatic cholangiogram)
- Abdominal CT scan
- Abdominal ultrasound
- CT scan-directed biopsy
- Cytology (examination of the cells obtained from either a CT biopsy or ERCP) that shows cholangiocarcinoma
Blood tests that reveal abnormal function:
- Liver function tests, elevated
- Bilirubin, elevated
Treatment
The goal is to treat the cancer and the obstruction it causes. When possible, surgical removal of the tumor is the treatment of choice and may result in cure. Chemotherapy or radiation may be given after surgery to decrease the risk of recurrence, but the benefit of this is not entirely clear.
Endoscopic therapy or surgery can clear obstructions in the biliary ducts and relieve jaundice in patients in whom the tumor is unresectable (cannot be removed).
Written and revised by
Gerald Hurowitz, M.D.
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