Cholangiocarcinoma

Case contributed by Dr MT Niknejad

Presentation

Abdominal pain.

Patient Data

Age: 30 years
Gender: Female
MRI

The gallbladder is not seen because of prior surgery.

A 60 x 55 mm solid mass is seen at the central part of the liver. It is low signal on T1WI and faint hyper signal on T2WI. After contrast injection, it shows marginal enhancement with progressive fill in. The left portal vein is encased by mass. 

There are six similar lesions in the liver inferring metastases.

Mild dilatation is seen at left bile ducts; CBD is not dilated.

A band like filling defect is seen at the main portal vein in favor of chronic thrombosis.

A few lymphadenopathies are noted porta hepatis with SAD less than 15 mm.

CT

A 65 x 50 mm low enhancing mass with internal calcifications is present at the central portion of the liver.

There are also six small low enhancing masses, less than 20 mm, scattered at the liver parenchyma.

A few lymphadenopathies are noted porta hepatis with SAD less than 15 mm.

Case Discussion

Pathology proven cholangiocarcinoma with hepatic metastases and porta hepatis lymphadenopathies.

Cholangiocarcinoma is the second most common primary hepatobiliary malignancy after hepatocellular carcinoma (HCC). They tend to have a poor prognosis and high morbidity. 

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