Cholangiocarcinoma

Question 1

Description: What is cholangiocarcinoma?

Answer 1

Cancer of the bile duct

Question 2

Aetiology/Risk Factors: What are the risk factors for developing cholangiocarcinoma? (6)

Answer 2

• Primary sclerosing cholangitis
• Congenital cystic disease
• Biliary - enteric drainage
• Carcinogens (aflatoxins)
• Hepatolithiasis (gallstones of hepatic duct)
• Thorotrast (contrast)

Question 3

Pathology: What are the 3 types of cholangiocarcinoma? (3)

Answer 3

3 types of cholangiocarcinoma:

• Mass forming
• Intraductal
• Periductal

Question 4

Symptoms: What symptom is associated with cholangiocarcinoma? (1)

Answer 4

• Itching

Question 5

Signs: What sign is associated with cholangiocarcinoma? (1)

Answer 5

• Obstructive jaundice

Question 6

Investigations: What investigations do we do for cholangiocarcinoma? (12)

Answer 6

• Blood tests
• Ultrasound scan
• Endoscopic ultrasound
• CT
• Magnetic resonance angiogram
• MRCP
• PTC
• Angiography
• FDC PET
• ERCP, Cholangioscopy and Cytology

Question 7

Treatment: What treatment do we do for cholangiocarcinoma:

a) Curative treatment (1
(b) Palliative treatment (4)

Answer 7

(a) Only curative treatment for intrahepatic cholangiocarcinoma:
- SURGERY

(b) Palliative treatment:
- Chemotherapy
- Radiotherapy
- Stenting
- Surgical bypass

Question 8

Complications:

Answer 8

XXX

Question 9

Extra: Can cholangiocarcinoma be intra-hepatic or extra-hepatic

Answer 9

Can be intrahepatic (rare) or extrahepatic (more common)