What is the most common manifestation of cholangiocarcinoma?

Daniel Catenacci MD

December 12, 2022

manifestation of cholangiocarcinoma

Symptoms of cholangiocarcinoma are typically divided into three categories: abdominal pain, blood in the stool, and bleeding from the colon. The latter two are the most common symptoms. You should see your physician immediately if you have any of the above symptoms. These symptoms can lead to life-threatening complications.

Perihilar cholangiocarcinoma

Among all biliary cancers, perihilar cholangiocarcinoma (CC) accounts for a relatively high percentage of the total. The main features of CC include the presence of a longitudinal tumor spread along the bile duct wall. Occasionally, it can involve the hepatic ducts.

Various diagnostic studies are essential for identifying CC. Multiparametric imaging techniques such as CT and MRCP are basic for comprehensively assessing cholangiocarcinogenesis and tumor invasion. The extent of tumor invasion into the bile duct is critical for surgical decisions.

The Bismuth-Corlette (BC) staging system is today’s most widely used system. However, it has substantial limitations in predicting patient prognosis. The BC system does not account for distant metastases and lymph node involvement.

Another classification system, the Deoliveira et al. staging system, is more comprehensive and includes the size and extent of the tumor in the bile duct. In addition, it also contains information about the presence of distant metastases.

Trisomy 7

NIPT (noninvasive prenatal testing) is a noninvasive prenatal screening technique for diagnosing common fetal chromosomal abnormalities in newborns. The results are comparable to those obtained by conventional cytology.

NIPT has suspected the chromosomal pattern of trisomy seven in 35 of 31,250 patients. The frequency of this finding is similar among laboratories. It has been associated with extrahepatic bile duct carcinoma.

Among malignant cases, trisomy 3 is more common. Four malignant specimens were identified with trisomy 3. A mild case was also found. A tetraploid population was seen in one of the cases. However, the presence of polysomy was deemed low risk. Trisomy three was found in a single cell in the remaining five malignant cases. The corresponding chromosomes are shown in table 1.

Cholangiocarcinoma is an atypical and heterogeneous biliary tract tumor. The bile ducts connect the gallbladder and the small intestine. These ducts are branched tubes that are connected to the liver. These ducts are blocked by a tumor, causing the patient to suffer from jaundice.


Symptoms of cholangiocarcinoma include jaundice, abdominal pain, weight loss, and other digestive problems. This type of cancer usually occurs in the bile ducts but can also develop in other liver parts. It is rare cancer and can be challenging to treat.

The first step to diagnosing cholangiocarcinoma is a physical examination. The doctor will look for lumps, fluid buildup, and tenderness. They may refer you to a specialist. The doctor will also review your medical history and risk factors.

If a tumor is present, the doctor may do an imaging test to see if it is cancerous. This will include an abdominal ultrasound or CT/MRI. These tests will show the tumor’s size and location. In addition, a sample of the tumor can be taken during an endoscopy. The pathologist will study the cells under the microscope to determine if the tumor is a cholangiocarcinoma.


Despite several different imaging techniques for diagnosing cholangiocarcinoma, there are still limitations to the accuracy of these procedures. Currently, there are no randomized clinical trials to assess the accuracy of these diagnostic methods.

The diagnosis of biliary tract cancer is based on clinical examination, blood tests, and imaging scans. In addition, patients may be referred to a specialist in the digestive system or oncology. The tumor can occur anywhere in the bile duct, including outside the liver. However, it is most common in the distal common bile duct and the hilar region.

In general, most biliary duct cancers have already spread by the time they are diagnosed. However, this does not mean that these cancers are incurable. Targeted therapies are beginning to change the prognosis for these cancers. The patient may be able to receive chemotherapy, radiation therapy, or a liver transplant.


Fortunately, there are many treatment options for cholangiocarcinoma. Depending on your diagnosis, your doctor may suggest chemotherapy, radiation therapy, surgery, or a combination.

Surgical treatment is the most common form of cholangiocarcinoma treatment. The surgeon will remove a portion of the liver or bile duct. Alternatively, the gallbladder and part of the pancreas may be removed. The surgery may also involve nearby lymph nodes depending on the cancer stage.

After the surgery, the patient may receive a stent to keep the bile duct open, and the bile flowing. Other treatments for bile duct cancer include chemotherapy, radiation therapy, and targeted therapy. The goal of each treatment is to kill the cancer cells and ensure they don’t grow again.

During radiation therapy, radioactive material is placed in the body near cancer. This may be done through internal or external beam radiation. In some cases, the chemo drugs are infused into a vein.