Cholangiocarcinoma is a cancerous (malignant) growth in one of the ducts that carries bile from the liver to the small intestine.
Cancerous tumors of the bile ducts are usually slow-growing and do not spread (metastasize) quickly. However, many of these tumors are already quite advanced by the time they are found. A cholangiocarcinoma may start anywhere along the bile ducts. These tumors block off the bile ducts. Both men and women are affected. Most patients are older than 65.
Risks of this condition include:
- Bile duct (choledochal) cysts
- Chronic biliary and liver inflammation
- History of infection with the parasitic worm, liver flukes
- Primary sclerosing cholangitis
- Ulcerative colitis
- Cholangiocarcinoma is rare. It occurs in approximately 2 out of 100,000 people.
Symptoms may include any of the following:
- Clay-colored stools
- Loss of appetite
- Pain in the upper right abdomen that may radiate to the back
- Weight loss
- Yellowing of the skin (jaundice)
Exams and Tests
Your health care provider will perform a physical exam. Tests will be done to check for a tumor or blockage in the bile duct. These may include:
- Abdominal CT scan
- Abdominal ultrasound
- CT scan-directed biopsy
- Cytology of samples from the bile duct
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Magnetic resonance cholangiopancreatography (MRCP)
- Percutaneous transhepatic cholangiogram (PTCA)
Blood tests that may be done include:
Liver function tests (especially alkaline phosphatase or bilirubin levels)
The goal is to treat the cancer and the blockage it causes. When possible, surgery to remove the tumor is the treatment of choice and may result in a cure. If the tumor is large, the entire liver may need to be removed and a liver transplant will be needed. Often the cancer has already spread locally or to another area of the body by the time it is diagnosed. As a result, surgery to cure the cancer is not possible.
Chemotherapy or radiation may be given after surgery to decrease the risk of the cancer returning. But the benefit of this treatment is not certain.
Endoscopic therapy with stent placement can temporarily relieve blockages in the biliary ducts and relieve jaundice in patients when the tumor cannot be removed. Laser therapy combined with light-activated chemotherapy medications is another treatment option for those with blockages of the bile duct.
If the tumor cannot be completely removed, a cure is generally not possible. With treatment, about half of these patients live a year, and about half live longer, but rarely beyond 5 years.
- Liver failure
- Spread (metastasis) of tumor to other organs