Cholangiocarcinoma

Question 1

what is cholangiocarcinoma

Answer 1

malignancy which originates in the bile ducts
majority are adenocarcinoma

Question 2

risk factors for cholangiocarcinoma

Answer 2

primary sclerosis cholangitis (UC pts)
liver flukes

Question 3

presentation of cholangiocarcinoma

Answer 3

obstructive jaundice: pale stools, dark urine, pruritus’
weight loss
RUQ pain
hepatomegaly
palpable gall bladder

Question 4

what is Courvoisier’s law

Answer 4

palpable gall bladder and painless jaundice
unlikely to be gall stones
often malignancy of the head of the pancreas

Question 5

which tumour marker is associated with cholangiocarcinoma

Answer 5

CA 19-9

Question 6

how would you investigate / diagnose cholangiocarcinoma

Answer 6

MRCP
ERCP with biopsy +/- stenting
staging CT CAP
PET CT

Question 7

general management of cholangiocarcinoma

Answer 7

curative resection can be done in early disease without mets or invasion into the local vasculatures
palliative: stenting, chemo/radiotherapy