ISSN: 1859 - 2872
Cholangiocarcinoma: A case series report
Main Article Content
Keywords
Cholangiocarcinoma, intrahepatic cholangiocarcinoma, perihilar cholangiocarcinoma, distal cholangiocarcinoma.
Abstract
Cholangiocarcinoma (CCA) is a rare malignancy with a high mortality rate due to late diagnosis and limited curative treatment options. This article presents three typical clinical cases of CCA, each involving different anatomical locations: cholangiocarcinoma, distal cholangiocarcinoma, and intrahepatic cholangiocarcinoma. These cases illustrate the variations in clinical presentation, biomarker levels, imaging findings, and histopathological features. The diversity and complexity of these cases underscore the diagnostic and therapeutic challenges associated with CCA.
Article Details
References
1. Bridgewater J, Galle PR, Khan SA et al (2014) Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma. Journal of hepatology 60(6): 1268-1289. doi:10.1016/j.jhep.2014.01.021
2. Blechacz B, Komuta M, Roskams T, Gores GJ (2011) Clinical diagnosis and staging of cholangiocarcinoma. Nature Reviews Gastroenterology & Hepatology 8(9): 512-522. doi:10.1038/nrgastro.2011.131.
3. Ilyas SI, Gores GJ (2013) Pathogenesis, diagnosis, and management of cholangiocarcinoma. Gastroenterology 145(6): 1215-29. doi: 10.1053/j.gastro.2013.10.013
4. Primary liver cancer in Japan The Liver Cancer Study Group of Japan. Cancer. Oct 15 1984;54(8):1747-55. doi:10.1002/1097-0142(19841015)54:8<1747::aid-cncr2820540846>3.0.co;2-l
5. Khan SA, Thomas HC, Davidson BR, Taylor-Robinson SD (2005) Cholangiocarcinoma. Lancet (London, England) 366(9493): 1303-1314. doi: 10.1016/s0140-6736(05)67530-7
6. Levy C, Lymp J, Angulo P, Gores GJ, Larusso N, Lindor KD (2005) The value of serum CA 19-9 in predicting cholangiocarcinomas in patients with primary sclerosing cholangitis. Digestive diseases and sciences 50(9): 1734-1740. doi:10.1007/s10620-005-2927-8
7. Nakanuma Y, Sato Y, Harada K, Sasaki M, Xu J, Ikeda H (2010) Pathological classification of intrahepatic cholangiocarcinoma based on a new concept. World journal of hepatology 2(12): 419-427. doi:10.4254/wjh.v2.i12.419
8. Hong SM, Pawlik TM, Cho H et al (2009) Depth of tumor invasion better predicts prognosis than the current American Joint Committee on Cancer T classification for distal bile duct carcinoma. Surgery 146(2): 250-257. doi:10.1016/j.surg.2009.02.023
9. Lim JH (2003) Cholangiocarcinoma: morphologic classification according to growth pattern and imaging findings. AJR American journal of roentgenology 181(3): 819-827. doi: 10.2214/ajr.181.3.1810819
10. Chung YE, Kim MJ, Park YN et al (2009) Varying appearances of cholangiocarcinoma: Radiologic-pathologic correlation. Radiographics: A review publication of the Radiological Society of North America, Inc 29(3): 683-700. doi:10.1148/rg.293085729
11. Shin DW, Moon SH, Kim JH (2023) Diagnosis of Cholangiocarcinoma. Diagnostics (Basel, Switzerland). 13(2)doi:10.3390/diagnostics13020233
12. Wang Y, Yang Q, Li S, Luo R, Mao S, Shen J (2019) Imaging features of combined hepatocellular and cholangiocarcinoma compared with those of hepatocellular carcinoma and intrahepatic cholangiocellular carcinoma in a Chinese population. Clinical radiology 74(5): 407.e1-407.e10. doi:10.1016/j.crad.2019.01.016
13. Jarnagin WR, Fong Y, DeMatteo RP et al (2001) Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma. Annals of surgery 234(4): 507-517; discussion 517-9. doi:10.1097/00000658-200110000-00010
14. DeOliveira ML, Cunningham SC, Cameron JL et al (2007) Cholangiocarcinoma: Thirty-one-year experience with 564 patients at a single institution. Annals of surgery 245(5): 755-762. doi:10.1097/01.sla.0000251366.62632.d3
15. Weber SM, Jarnagin WR, Klimstra D, DeMatteo RP, Fong Y, Blumgart LH (2001) Intrahepatic cholangiocarcinoma: Resectability, recurrence pattern, and outcomes. Journal of the American College of Surgeons 193(4): 384-391. doi:10.1016/s1072-7515(01)01016-x
16. Neuhaus P, Jonas S, Bechstein WO et al (1999) Extended resections for hilar cholangiocarcinoma. Annals of surgery. 230(6): 808-818; discussion 819. doi:10.1097/00000658-199912000-00010
17. Silva MA, Tekin K, Aytekin F, Bramhall SR, Buckels JA, Mirza DF (2005) Surgery for hilar cholangiocarcinoma; a 10 year experience of a tertiary referral centre in the UK. European journal of surgical oncology: The journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 31(5): 533-539. doi:10.1016/j.ejso.2005.02.021.
18. Pichlmayr R, Weimann A, Klempnauer J et al (1996) Surgical treatment in proximal bile duct cancer. A single-center experience. Annals of surgery 224(5): 628-638. doi:10.1097/00000658-199611000-00007
19. Darwish Murad S, Kim WR, Harnois DM et al (2012) Efficacy of neoadjuvant chemoradiation, followed by liver transplantation, for perihilar cholangiocarcinoma at 12 US centers. Gastroenterology 143(1):88-98.e3; quiz e14. doi:10.1053/j.gastro.2012.04.008
20. Valle J, Wasan H, Palmer Daniel H et al. Cisplatin plus Gemcitabine versus Gemcitabine for Biliary Tract Cancer. New England Journal of Medicine. 362(14): 1273-1281. doi:10.1056/NEJMoa0908721
21. Primrose JN, Fox RP, Palmer DH et al (2019) Capecitabine compared with observation in resected biliary tract cancer (BILCAP): A randomised, controlled, multicentre, phase 3 study. The Lancet Oncology 20(5): 663-673. doi:10.1016/s1470-2045(18)30915-x
22. Weber SM, Ribero D, O'Reilly EM, Kokudo N, Miyazaki M, Pawlik TM (2015) Intrahepatic cholangiocarcinoma: Expert consensus statement. HPB: The official journal of the International Hepato Pancreato Biliary Association. Aug 2015;17(8):669-80. doi:10.1111/hpb.12441
23. Chang YJ, Chang YJ, Chen LJ (2024) Prognostic factors in patients with intrahepatic cholangiocarcinoma. Scientific reports 14(1):19084. doi:10.1038/s41598-024-70124-z
24. Anderson CD, Pinson CW, Berlin J, Chari RS (2004) Diagnosis and treatment of cholangiocarcinoma. The oncologist 9(1): 43-57. doi:10.1634/theoncologist.9-1-43
25. Farges O, Fuks D, Boleslawski E et al (2011) Influence of surgical margins on outcome in patients with intrahepatic cholangiocarcinoma: a multicenter study by the AFC-IHCC-2009 study group. Annals of surgery. 254(5): 824-829; discussion 830. doi:10.1097/SLA.0b013e318236c21d
2. Blechacz B, Komuta M, Roskams T, Gores GJ (2011) Clinical diagnosis and staging of cholangiocarcinoma. Nature Reviews Gastroenterology & Hepatology 8(9): 512-522. doi:10.1038/nrgastro.2011.131.
3. Ilyas SI, Gores GJ (2013) Pathogenesis, diagnosis, and management of cholangiocarcinoma. Gastroenterology 145(6): 1215-29. doi: 10.1053/j.gastro.2013.10.013
4. Primary liver cancer in Japan The Liver Cancer Study Group of Japan. Cancer. Oct 15 1984;54(8):1747-55. doi:10.1002/1097-0142(19841015)54:8<1747::aid-cncr2820540846>3.0.co;2-l
5. Khan SA, Thomas HC, Davidson BR, Taylor-Robinson SD (2005) Cholangiocarcinoma. Lancet (London, England) 366(9493): 1303-1314. doi: 10.1016/s0140-6736(05)67530-7
6. Levy C, Lymp J, Angulo P, Gores GJ, Larusso N, Lindor KD (2005) The value of serum CA 19-9 in predicting cholangiocarcinomas in patients with primary sclerosing cholangitis. Digestive diseases and sciences 50(9): 1734-1740. doi:10.1007/s10620-005-2927-8
7. Nakanuma Y, Sato Y, Harada K, Sasaki M, Xu J, Ikeda H (2010) Pathological classification of intrahepatic cholangiocarcinoma based on a new concept. World journal of hepatology 2(12): 419-427. doi:10.4254/wjh.v2.i12.419
8. Hong SM, Pawlik TM, Cho H et al (2009) Depth of tumor invasion better predicts prognosis than the current American Joint Committee on Cancer T classification for distal bile duct carcinoma. Surgery 146(2): 250-257. doi:10.1016/j.surg.2009.02.023
9. Lim JH (2003) Cholangiocarcinoma: morphologic classification according to growth pattern and imaging findings. AJR American journal of roentgenology 181(3): 819-827. doi: 10.2214/ajr.181.3.1810819
10. Chung YE, Kim MJ, Park YN et al (2009) Varying appearances of cholangiocarcinoma: Radiologic-pathologic correlation. Radiographics: A review publication of the Radiological Society of North America, Inc 29(3): 683-700. doi:10.1148/rg.293085729
11. Shin DW, Moon SH, Kim JH (2023) Diagnosis of Cholangiocarcinoma. Diagnostics (Basel, Switzerland). 13(2)doi:10.3390/diagnostics13020233
12. Wang Y, Yang Q, Li S, Luo R, Mao S, Shen J (2019) Imaging features of combined hepatocellular and cholangiocarcinoma compared with those of hepatocellular carcinoma and intrahepatic cholangiocellular carcinoma in a Chinese population. Clinical radiology 74(5): 407.e1-407.e10. doi:10.1016/j.crad.2019.01.016
13. Jarnagin WR, Fong Y, DeMatteo RP et al (2001) Staging, resectability, and outcome in 225 patients with hilar cholangiocarcinoma. Annals of surgery 234(4): 507-517; discussion 517-9. doi:10.1097/00000658-200110000-00010
14. DeOliveira ML, Cunningham SC, Cameron JL et al (2007) Cholangiocarcinoma: Thirty-one-year experience with 564 patients at a single institution. Annals of surgery 245(5): 755-762. doi:10.1097/01.sla.0000251366.62632.d3
15. Weber SM, Jarnagin WR, Klimstra D, DeMatteo RP, Fong Y, Blumgart LH (2001) Intrahepatic cholangiocarcinoma: Resectability, recurrence pattern, and outcomes. Journal of the American College of Surgeons 193(4): 384-391. doi:10.1016/s1072-7515(01)01016-x
16. Neuhaus P, Jonas S, Bechstein WO et al (1999) Extended resections for hilar cholangiocarcinoma. Annals of surgery. 230(6): 808-818; discussion 819. doi:10.1097/00000658-199912000-00010
17. Silva MA, Tekin K, Aytekin F, Bramhall SR, Buckels JA, Mirza DF (2005) Surgery for hilar cholangiocarcinoma; a 10 year experience of a tertiary referral centre in the UK. European journal of surgical oncology: The journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 31(5): 533-539. doi:10.1016/j.ejso.2005.02.021.
18. Pichlmayr R, Weimann A, Klempnauer J et al (1996) Surgical treatment in proximal bile duct cancer. A single-center experience. Annals of surgery 224(5): 628-638. doi:10.1097/00000658-199611000-00007
19. Darwish Murad S, Kim WR, Harnois DM et al (2012) Efficacy of neoadjuvant chemoradiation, followed by liver transplantation, for perihilar cholangiocarcinoma at 12 US centers. Gastroenterology 143(1):88-98.e3; quiz e14. doi:10.1053/j.gastro.2012.04.008
20. Valle J, Wasan H, Palmer Daniel H et al. Cisplatin plus Gemcitabine versus Gemcitabine for Biliary Tract Cancer. New England Journal of Medicine. 362(14): 1273-1281. doi:10.1056/NEJMoa0908721
21. Primrose JN, Fox RP, Palmer DH et al (2019) Capecitabine compared with observation in resected biliary tract cancer (BILCAP): A randomised, controlled, multicentre, phase 3 study. The Lancet Oncology 20(5): 663-673. doi:10.1016/s1470-2045(18)30915-x
22. Weber SM, Ribero D, O'Reilly EM, Kokudo N, Miyazaki M, Pawlik TM (2015) Intrahepatic cholangiocarcinoma: Expert consensus statement. HPB: The official journal of the International Hepato Pancreato Biliary Association. Aug 2015;17(8):669-80. doi:10.1111/hpb.12441
23. Chang YJ, Chang YJ, Chen LJ (2024) Prognostic factors in patients with intrahepatic cholangiocarcinoma. Scientific reports 14(1):19084. doi:10.1038/s41598-024-70124-z
24. Anderson CD, Pinson CW, Berlin J, Chari RS (2004) Diagnosis and treatment of cholangiocarcinoma. The oncologist 9(1): 43-57. doi:10.1634/theoncologist.9-1-43
25. Farges O, Fuks D, Boleslawski E et al (2011) Influence of surgical margins on outcome in patients with intrahepatic cholangiocarcinoma: a multicenter study by the AFC-IHCC-2009 study group. Annals of surgery. 254(5): 824-829; discussion 830. doi:10.1097/SLA.0b013e318236c21d
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Published
May 15, 2026
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How to Cite
ĐứcN. T., ThạchN. V., Minh HạnhN. T., Thu HằngT. T., & MaiN. T. (2026). Cholangiocarcinoma: A case series report. Tạp Chí Y Dược lâm sàng 108, 21(4). https://doi.org/10.52389/ydls.v21i4.3017