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Intrahepatic Cholangiocarcinoma: Diagnosis

What is Cholangiocarcinoma?

Cholangiocarcinoma is a type of cancerous liver lesion that can develop in any part of the bile ducts. The bile ducts are narrow tubes that carry bile from the liver and gallbladder through the pancreas to the duodenum (small intestine).

Also known as bile duct cancer, cholangiocarcinoma, is a very rare cancer that typically occurs in people over the age of 50. Each year, about 6,000 people in the United States develop cholangiocarcinoma.

What is Intrahepatic Cholangiocarcinoma?

Intrahepatic cholangiocarcinoma develops in the parts of the bile ducts within the liver. Malignant in nature, it is often referred to as a type of liver cancer rather than bile duct cancer.

Only 10% of bile duct cancers are intrahepatic cholangiocarcinoma.

Other Types of Cholangiocarcinoma

Based on the location of the tumor, cholangiocarcinoma is classified into three types:

Perihilar Cholangiocarcinoma

Perihilar cholangiocarcinoma, also called hilar cholangiocarcinoma, develops in the parts of the bile ducts just outside the liver.

It accounts for more than half of all bile duct cancers, making it the most common type of cholangiocarcinoma.

Distal Cholangiocarcinoma

Distal cholangiocarcinoma develops in the part of the bile duct closest to the small intestine, outside of the liver.

Distal bile duct cancer accounts for 20 – 30% of cholangiocarcinoma cancers.

Intrahepatic Cholangiocarcinoma Detection

Cholangiocarcinoma is extremely rare and difficult to detect.

Intrahepatic cholangiocarcinoma especially can easily be mistaken as other types of liver lesions. This poses a huge diagnostic danger, as all types of cholangiocarcinoma require immediate attention, whereas many liver lesions can be left alone.

The chance of survival for patients with intrahepatic cholangiocarcinoma largely depends on its location and how advanced it is at the time of detection.

In order to prevent misdiagnosis, radiographic images should be interpreted by an experienced subspecialty radiologist. General radiologists do not have the expertise needed to differentiate between different types of lesions. Familiarity comes with years of experience.

Diagnosing Intrahepatic Cholangiocarcinoma

Intrahepatic cholangiocarcinoma is often detected incidentally during blood work or radiographic image testing for an unrelated issue.

While an ultrasound is useful for detecting the presence of a liver lesion, CT, MRI, or, in some cases, a biopsy, is needed to determine the type of lesion.

Intrahepatic Cholangiocarcinoma Symptoms

Not all patients with intrahepatic cholangiocarcinoma will experience symptoms. However, some may experience mild abdominal discomfort. Patients with advanced stage cholangiocarcinoma can develop symptoms similar to liver disease.

Signs of cholangiocarcinoma may include:

  • Weight lose
  • Yellowing of the skin and eyes (jaundice)
  • Itchy skin
  • White-colored stools
  • Fatigue
  • Abdominal pain

Intrahepatic Cholangiocarcinoma Treatment

Treating intrahepatic cholangiocarcinoma depends on the extent of the cancer. When possible, surgery is the preferred way to treat cholangiocarcinoma, offering the best chance of survival.

Upon diagnosing cholangiocarcinoma, doctors will decide if the cancer is resectable cancer (cholangiocarcinoma that can be completely removed by surgery), or unresectable cancer (cholangiocarcinoma that has spread too far or is too difficult to be fully removed by surgery).

Unfortunately, most bile duct cancers – including intrahepatic cholangiocarcinoma – are unresectable by the time they’re found. Early diagnosis is critical for successful treatment. When a liver lesion is found, image interpretation by an experienced, fellowship-trained subspecilaty radiologist is imperative. Getting a second opinion is highly recommended for such cases.

For bile duct cancers that cannot initially be completely removed by surgery, a combination of chemotherapy and radiation may be used to shrink the cancer. Thereafter, surgery may be an option. For intrahepatic cholangiocarcinoma, ablation with either extreme heat or extreme cold may be used to treat and control the tumor. Liver transplant may be an option for some patients, although finding a doner is difficult.

Get a Subspecialty Second Opinion Today

The DocPanel platform enables people all over the world to get an expert second opinion in as little as 24 – 72 hours.

An easy 3-step process – instantly upload your scans, select an expert subspecialty radiologist (or have DocPanel assign your case to the appropriate subspecialist), and submit your request. Upon uploading your scans, you’ll also have the opportunity to ask any questions you might have about your case.
Not sure what a subspecialist is? Learn more with our in-depth article on the importance of getting a second opinion from a subspecialty radiologist.

Get your scans interpreted by one of the nation’s leading abdominal subspecialists, Dr. Semelka, or explore DocPanel’s complete team of subspecialty radiologists. Request a second opinion today.

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