Intrahepatic cholangiocarcinomas (ICCs) are the second most common liver malignancy, and they arise from bile duct epithelium within the liver.
Bile duct is a 4 to 5 inches long thin tube, which reaches from the liver to the small intestine. The main function of the bile duct is to move a bile fluid from the liver and gallbladder to the small intestine, where it helps in digesting the fats in food.
Different bile ducts system has different names. In the liver it begins in ductules which then merge into larger ducts and eventually the left and right hepatic ducts. The ducts within the liver are called intrahepatic bile ducts. These ducts exit from the liver and join to form the common hepatic duct at the hilum. About one-third of the way along the length of the bile duct, the gallbladder attaches by a small duct called the cystic duct. The combined duct is called the common bile duct.
Intrahepatic Cholangiocarcinoma develops in the smaller bile duct branches inside the liver. Below in this article, you will find an information about Intrahepatic Cholangiocarcinoma, its symptoms, Survival Rate, Prognosis and Treatments.
Intrahepatic cholangiocarcinoma (ICC), which is a primary cancer of the bile ducts. it arises from malignant transmutation of the epithelial cells that line the biliary apparatus. They can sometimes be confused with cancers that start in the liver cells. Only 10% of bile duct cancers are intrahepatic.
In most cases, cholangiocarcinoma arises in those parts of the bile ducts that lie outside the liver. Rarely, cancer can develop in ducts that are located within the liver.
What Causes Intrahepatic Cholangiocarcinoma?
The Specialists does not know why cholangiocarcinoma develops, but it is believed that chronic inflammation of the bile ducts and chronic parasitic infections can play a part.
There are approximately 2,500 cases of cholangiocarcinoma reported in the United States each year.
Who Is at Risk for Intrahepatic Cholangiocarcinoma?
Male and people older than 65 years of age are more likely to develop cholangiocarcinoma. Other conditions that can increase the risk for this type of cancer, includes:
- bile duct infections
- ulcerative colitis
- liver fluke (parasitic flatworm) infections
- exposure to chemicals used in industries such as aircraft manufacturing
Intrahepatic Cholangiocarcinoma Symptoms
Symptoms may vary depending on the location of tumor, but they can include general symptoms:
- chills and fever
- loss of appetite
- weight loss
The major signs and symptoms may include:
- jaundice — the most common sign, which may develop at an early or late stage, depending on the tumor site
- dark urine
- itching — this can be caused by jaundice
- pain in the abdomen
An additional rare but serious symptom is the enlargement of your liver, spleen, or gallbladder.
Intrahepatic Cholangiocarcinoma Diagnosis
Blood tests can check how well the liver is functioning and can be used to look for substances called tumor markers. Levels of tumor markers rise in people with cholangiocarcinoma.
Ultrasound, CT (computerized tomography) scan, and MRI (magnetic resonance imaging) provide pictures of bile ducts and the areas around them and can show tumors when they are present. Imaging scans can also assist to guide the surgeons’ movements if they choose biopsy to check for cancer cells.
ERCP (endoscopic retrograde cholangiopancreatography)
ERCP procedure is sometimes carried out by a long tube with a camera. It is passed down through a throat and into the part of a gut where the bile ducts open. The surgeon injects dye into the bile ducts which improve the ducts more clear on an X-ray, showing any blockages. In some cases, a probe that takes ultrasound pictures is also passed down into the area of your bile ducts. This is called an endoscopic ultrasound scan.
Intrahepatic Cholangiocarcinoma Treatment
The treatment of Intrahepatic cholangiocarcinomas vary according to the location and size of tumor, whether it has spread (metastasized), and the overall health.
Surgical treatment is the only option that offers a cure, especially if cancer has been identified early and has not spread beyond liver or bile ducts. Sometimes, if a tumor is still confined to the bile ducts, only ducts are removed. If cancer has spread beyond the ducts and into liver, a section of the liver, or even entire liver, may have to be removed. If the whole liver is removed, a liver transplant will be required to replace it.
If cancer has penetrated nearby organs, a Whipple’s procedure is carried out. Here, the bile ducts, gallbladder, pancreas, and sections of stomach and gut are removed. The patient might need to take chemotherapy or radiation treatments following your surgery.
Intrahepatic Cholangiocarcinoma Survival Rate
If it is possible to remove the tumor entirely, there is a possibility of being cured. Up to 40 percent of people who have their tumors removed will survive for five years or more. Outlook is generally better if the tumor is not located in liver.
Unfortunately, close to 90 percent of patients are not eligible for surgery to remove all or part of the liver or bile duct to remove the tumor because their cancer has already metastasized, or is in an inoperable location. In general, cholangiocarcinoma patients survive for about 12 to18 months after diagnosis.