Symptoms
Signs and symptoms of cholangiocarcinoma include:
- Yellowing of your skin and the whites of your eyes (jaundice)
- Intensely itchy skin
- White-colored stools
- Fatigue
- Abdominal pain
- Unintended weight loss
When to see a doctor
See your doctor if you have persistent fatigue, abdominal pain, jaundice, or other signs and symptoms that bother you. He or she may refer you to a specialist in digestive diseases (gastroenterologist).
Causes
Cholangiocarcinoma occurs when cells in the bile ducts develop changes (mutations) in their DNA — the material that provides instructions for every chemical process in your body. DNA mutations cause changes in the instructions. One result is that cells may begin to grow out of control and eventually form a tumor — a mass of cancerous cells. It's not clear what causes the genetic mutations that lead to cancer.
Risk factors
Factors that may increase your risk of cholangiocarcinoma include:
- Primary sclerosing cholangitis. This disease causes hardening and scarring of the bile ducts.
- Chronic liver disease. Scarring of the liver caused by a history of chronic liver disease increases the risk of cholangiocarcinoma.
- Bile duct problems present at birth. People born with a choledochal cyst, which causes dilated and irregular bile ducts, have an increased risk of cholangiocarcinoma.
- A liver parasite. In areas of Southeast Asia, cholangiocarcinoma is associated with liver fluke infection, which can occur from eating raw or undercooked fish.
- Older age. Cholangiocarcinoma occurs most often in adults over age 50.
- Smoking. Smoking is associated with an increased risk of cholangiocarcinoma.
April 25, 2017
References
- AskMayoExpert. Cholangiocarcinoma. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
- Feldman M, et al. Tumors of the bile ducts, gallbladder and ampulla. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed Feb. 22, 2016.
- Rizvi S, et al. Current diagnostic and management options in perihilar cholangiocarcinoma. Digestion. 2014;89:216.
- Zaydfudim VM, et al. Hilar cholangiocarcinoma. Surgical Oncology Clinics of North America. 2014;23:247.
- Riggin EA. Allscipts EPSi. Mayo Clinic, Rochester, Minn. Oct. 27, 2016.
- Brown AY. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Nov. 3, 2016.
- Smoot RL (expert opinion). Mayo Clinic, Rochester, Minn. March 23, 2017.
- Choi J, et al. Aspirin use and the risk of cholangiocarcinoma. Hepatology. 2016;64:785.
- Doherty B, et al. Update on the diagnosis and treatment of cholangiocarcinoma. Current Gastroenterology Reports. 2017;19:2.
- Borad MJ, et al. Integrated genomic characterization reveals novel, therapeutically relevant drug targets in FGFR and EGFR pathways in sporadic intrahepatic cholangiocarcinoma. PloS Genetics 2014;10:e1004135. http://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1004135. Accessed Feb. 27, 2017.
- Barbara Woodward Lips Patient Education Center. Surgery on the extrahepatic bile duct, duodenum, papilla, or pancreas. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Merck Manual Professional Version. Tumors of the gallbladder and bile ducts. https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/tumors-of-the-gallbladder-and-bile-ducts#v902250. Accessed Feb. 28, 2017.
- Bergquist JR, et al. Implications of CA19-9 elevation for survival, staging and treatment sequencing in intrahepatic cholangiocarcinoma: A national cohort analysis. Journal of Surgical Oncology. 2016;114:475.
Cholangiocarcinoma (bile duct cancer)