cholangiocarcinoma

Question 1

cholangiocarcinoma

Answer 1

cancer originating in bile ducts

most often adenocarcinoma

Question 2

most common site

Answer 2

perihilar region

where R and L hepatic ducts have just become common hepatic duct

Question 3

key risk factors

Answer 3

primary sclerosing cholangitis ( worth remembering assoc w UC)
liver flukes (parasitic infection)

Question 4

presentation

Answer 4

obstructive jaundice pale stools, dark urine, itching
weight loss
RUQ pain
palpable gallbladder

Question 5

Couroisier’s law

Answer 5

palpable gallbladder along with jaundice unlikely to be gallstones

cause usually cholangiocarcinoma or pancreatic cancer (P ca more common)

Question 6

Ix

Answer 6

staging CT
CA19-9
MRCP
ERCP + biopsy

Question 7

Mx

Answer 7

curative surgery if early disease, can be used with chemo/radio

most often palliation

Question 8

Mx - palliative treatment

Answer 8

stent
chemo
radio
symptom control