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Intrahepatic Cholangiocarcinoma

CCA


Presentation

  • CASE REPORT We present a case of a 67-year-old female initially presenting with chest pain at rest, found to have a lung nodule on diagnostic imaging at the time of admission.[ncbi.nlm.nih.gov]
Weight Loss
  • Other common symptoms at presentation include abdominal pain, weight loss, and fever.[ncbi.nlm.nih.gov]
  • Abstract A 48-year-old Egyptian woman presented with 8 months of sharp right upper chest pain and weight loss.[acgcasereports.gi.org]
  • Signs and symptoms include malaise, weight loss, right upper quadrant abdominal pain, and night sweats. Early detection is difficult and the prognosis is generally poor.[icd10data.com]
  • Symptoms of cholangiocarcinoma (bile duct cancer) include: Jaundice Abdominal pain Fever Weight loss Weakness Itching How is cholangiocarcinoma diagnosed? When you see your physician you will have a routine examination.[hopkinsmedicine.org]
Fatigue
  • When to see a doctor See your doctor if you have persistent fatigue, abdominal pain, jaundice, or other signs and symptoms that bother you.[mayoclinic.org]
  • Patients may have non-specific symptoms including weight loss, abdominal pain, fevers, night sweats and fatigue.[rarediseases.org]
  • Many patients with CCA often present with non-specific symptoms such as cachexia, abdominal pain, night sweats, and fatigue which can precede or follow altered hepatocellular and biliar function tests.[omicsonline.org]
  • Toxicity Most patients developed fatigue. Six patients had symptomatic nausea requiring medication (18% Grade II toxicity). There were four Grade III adverse effects (12%).[jcancer.org]
Anorexia
  • A 44-year-old man admitted to the hospital with complaints of abdominal distension, edema of both legs, back pain and anorexia of 30 d' duration.[ncbi.nlm.nih.gov]
Anemia
  • The major toxic effect was grade 3 anemia, occurring in 1 patient (4.5%). Combination chemotherapy with arterial IA-call plus oral S-1 is an effective regimen that may improve survival in patients with unresectable intrahepatic cholangiocarcinoma.[ncbi.nlm.nih.gov]
Hoarseness
  • Here we report such a case of a 51-year old obese male presenting with hoarseness and trouble swallowing for 2 to 3 months.[ncbi.nlm.nih.gov]
Abdominal Pain
  • The patient was subsequently admitted to our hospital with abdominal pain and underwent right hemicolectomy with partial resection of hepatic segment V.[ncbi.nlm.nih.gov]
Nausea
  • Case Presentation A 30-years-old Caucasian man with no significant medical history was admitted at the Emergency Department with acute upper abdominal pain, nausea and vomiting.[omicsonline.org]
  • Six patients had symptomatic nausea requiring medication (18% Grade II toxicity). There were four Grade III adverse effects (12%). Two patients developed duodenal ulceration, one patient had cholangitis and one patient developed a liver abscess.[jcancer.org]
  • Symptoms, when present, include abdominal pain, malaise, night sweats, asthenia, nausea and weight loss.[em-consulte.com]
Vomiting
  • A 23-year-old female was noted with intermittent right upper abdominal distension, abdominal pain, and vomiting after eating for more than 1 month.[ncbi.nlm.nih.gov]
  • Case Presentation A 30-years-old Caucasian man with no significant medical history was admitted at the Emergency Department with acute upper abdominal pain, nausea and vomiting.[omicsonline.org]
Jaundice
  • He presented with jaundice and computed tomography showed a 4-cm, hypodense tumor in segment VIII of the liver. Microscopically, the resected mass was composed of well-differentiated adenocarcinoma cells.[ncbi.nlm.nih.gov]
Hepatic Mass
  • CASE PRESENTATION: Two patients with chronic hepatitis B were referred to our hospital due to a hepatic mass. Patient 1 had a 6.4 cm multinodular hepatic mass in the left lobe and a small nodule in the right lobe.[ncbi.nlm.nih.gov]
  • Triple-phase CT revealed a hepatic mass in segment IV A and IV B measuring approximately 5.8 x 6.4 x 6.8 cm.[acgcasereports.gi.org]
  • MRI showing multiple hepatic masses. B. A mass comprising often large ducts abuts uninvolved liver. C. CK7 immunostain emphasizes large, often adjoining ducts. D. Trichrome stain shows spread of tumor into scar with collagen deposition. E.[librepathology.org]
  • The liver is the most frequent metastatic site of colorectal cancer, and therefore, hepatic masses of patients who have colorectal cancer are usually diagnosed as a metastasis of colorectal cancer.[surgicalcasereports.springeropen.com]
Hepatomegaly
  • On physical examination, cardiac and pulmonary function was normal; the abdomen was tender in the upper quadrant and revealed hepatomegaly (upon palpation liver inferior margin was 3 cm below the right costal margin on the midclavicular line, the liver[omicsonline.org]
Back Pain
  • A 44-year-old man admitted to the hospital with complaints of abdominal distension, edema of both legs, back pain and anorexia of 30 d' duration.[ncbi.nlm.nih.gov]
Pruritus
  • BACKGROUND Intrahepatic cholangiocarcinoma is a rare condition which typically occurs in males between 50 and 70 years of age, and presents with symptoms related to biliary obstruction including jaundice, pruritus, and dark urine.[ncbi.nlm.nih.gov]
  • Palliative therapy Relief of biliary obstruction is warranted when symptoms such as pruritus and hepatic dysfunction outweigh other symptoms of the cancer.[northshore.org]
  • It was also recently demonstrated that the increase in opioidergic tone by the central administration of Morphine, binding to the mu- Opioid Receptor, is associated with pruritus (classical sing of cholestasis) in patients with primary biliary cirrhosis[omicsonline.org]
Dark Urine
  • BACKGROUND Intrahepatic cholangiocarcinoma is a rare condition which typically occurs in males between 50 and 70 years of age, and presents with symptoms related to biliary obstruction including jaundice, pruritus, and dark urine.[ncbi.nlm.nih.gov]
  • urine may also occur. [4] Other biliary tract cancers include gallbladder cancer and cancer of the ampulla of Vater. [7] Risk factors for cholangiocarcinoma include primary sclerosing cholangitis (an inflammatory disease of the bile ducts), ulcerative[en.wikipedia.org]

Treatment

  • She received oral apatinib treatment since September 30, 2017. Due to related adverse reactions, the patient could not tolerate the treatment, and the subsequent reduction therapy was given.[ncbi.nlm.nih.gov]

Prognosis

  • The prognosis of sarcomatous ICC is poorly understood. We analyzed the prognosis of sarcomatous ICC by reviewing the previous reports and our own case. Only 15 cases of sarcomatous ICC have been reported in the English-language literature so far.[ncbi.nlm.nih.gov]

Etiology

  • These data highlight the relative importance of ICC etiology relative to established clinicopathological factors in the prognosis of patients with ICC.[ncbi.nlm.nih.gov]
  • BACKGROUND & AIMS: Intrahepatic cholangiocarcinoma (iCCA) is a heterogeneous entity with diverse etiologies, morphologies, and clinical outcomes.[bric.ku.dk]

Epidemiology

  • KEYWORDS: cirrhosis; epidemiology; hepatitis; hepatocellular carcinoma; intrahepatic cholangiocarcinoma[ncbi.nlm.nih.gov]
  • ; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute.[journals.plos.org]
Sex distribution
Age distribution

Pathophysiology

  • We report 2 cases of ICC that presented with a background of hepatitis B virus (HBV) infection and discuss the possible pathophysiological relationships between ICC and HBV infection, with an emphasis on the x gene of HBV.[ncbi.nlm.nih.gov]
  • In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. . Accessed Feb. 22, 2016. Rizvi S, et al.[mayoclinic.org]
  • […] common in East Asia, due to endemic liver fluke infection More common in older patients (over 75% of patients are older than 65 at initial diagnosis) ( Gastroenterology 2009;136:1134 ) Slightly more common in males than females ( Hepatology 2011;54:173 ) Pathophysiology[pathologyoutlines.com]
  • […] dioxide which was used as a radiologic contrast medium, has been linked to the development of cholangiocarcinoma as late as 30–40 years after exposure; Thorotrast was banned in the United States in the 1950s due to its carcinogenicity. [35] [36] [37] Pathophysiology[en.wikipedia.org]

Prevention

  • Some of these risk factors are either potentially preventable (eg, alcohol and tobacco use) or are currently treatable (eg hepatitis infection).[ncbi.nlm.nih.gov]

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