What to Do in a Patient Suspected of Having Cholangiocarcinoma?

Cholangiocarcinoma is a rare malignant tumor arising from the biliary epithelium. Despite advances in diagnostic techniques during the past decade, cholangiocarcinoma is usually encountered at an advanced stage due to the late presentation of symptoms. Clinical presentation of cholangiocarcinoma depends in part on the location of the tumor within the biliary system. Intrahepatic cholangiocarcinoma presents with nonspecific symptoms including malaise, weight lost, abdominal pain, and diminished appetite and rarely as an incidental abdominal mass. Patients with extrahepatic cholangiocarcinoma present with painless jaundice, pruritis, dark urine, pale stools, and occasionally cholangitis. 1.