Clinical presentation, diagnosis and staging of cholangiocarcinoma

Liver Int. 2019 May:39 Suppl 1:98-107. doi: 10.1111/liv.14086. Epub 2019 Mar 25.


Cholangiocarcinoma (CCA) is a heterogeneous group of tumours, derived from cells of the biliary tree, which represent the second most frequent primary liver tumour. According to the most recent classifications, CCA can be subdivided into intrahepatic (iCCA) and extrahepatic (eCCA) which include perihilar (pCCA) and distal (dCCA) CCA. CCA are usually identified at advanced stages, when the primary tumour grows enough to produce a large liver mass or when jaundice has developed because of biliary tree obstruction. The ongoing challenges in the identification of risk factors and definition of a specific population at higher risk of developing CCA are the main challenges for the development of screening programs. Therefore, late diagnosis remains an unresolved issue in CCA. Imaging plays an important role in the detection and characterization of CCA, helping with radiological diagnosis, guiding biopsy procedures and allowing staging of the tumour. This review focuses on clinical presentations and diagnosis and staging techniques of CCA.

Keywords: cholangiocarcinoma; clinical presentation; diagnosis; jaundice; staging.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Bile Duct Neoplasms / diagnostic imaging*
  • Bile Duct Neoplasms / pathology*
  • Bile Ducts, Extrahepatic / pathology
  • Bile Ducts, Intrahepatic / pathology
  • Cholangiocarcinoma / diagnostic imaging*
  • Cholangiocarcinoma / pathology*
  • Diagnostic Imaging / methods*
  • Humans
  • Neoplasm Staging
  • Risk Factors