Primary sclerosing cholangitis and cholangiocarcinoma as a diagnostic and therapeutic dilemma - PubMed (original) (raw)
Affiliations
- PMID: 10436794
Review
Primary sclerosing cholangitis and cholangiocarcinoma as a diagnostic and therapeutic dilemma
D J van Leeuwen et al. Ann Oncol. 1999.
Abstract
Differentiating primary sclerosing cholangitis (PSC) from cholangiocarcinoma (CC) can be a diagnostic challenge with major therapeutic implications. In case of advanced or symptomatic PSC, liver transplantation (OLTx) can be life saving with excellent long-term outcome. However, the outcome of CC diagnosed prior or during OLTx is dismal. PSC is a premalignant condition associated with a risk of developing cholangio- or hepatocellular carcinoma in > 15% of patients. Imaging diagnoses should be integrated into the further clinical data. It is the sudden, rapid and irreversible deterioration of the patient's condition, and the rapid progression of cholangiographic abnormalities, which may strongly point towards a malignancy or a malignant evolution in case of PSC. Brush cytology, (guided) biopsy, and tumor markers such as Ca 19.9 and CEA levels can be of some help, but confirmation of malignancy is often associated with a poor outcome and exclusion from liver transplantation. Clinical deterioration of the PSC patient and signs indicating advanced liver damage are a justification to evaluate patients for liver transplantation. Early transplantation should be considered in appropriate patients.
Similar articles
- Screening and diagnosis of cholangiocarcinoma in patients with primary sclerosing cholangitis.
Jesudian AB, Jacobson IM. Jesudian AB, et al. Rev Gastroenterol Disord. 2009 Spring;9(2):E41-7. Rev Gastroenterol Disord. 2009. PMID: 19668124 Review. - Early detection and treatment of cholangiocarcinoma.
Gores GJ. Gores GJ. Liver Transpl. 2000 Nov;6(6 Suppl 2):S30-4. doi: 10.1053/jlts.2000.18688. Liver Transpl. 2000. PMID: 11084082 Review. - Clinical clues to suspicion of IgG4-associated sclerosing cholangitis disguised as primary sclerosing cholangitis or hilar cholangiocarcinoma.
Oh HC, Kim MH, Lee KT, Lee JK, Moon SH, Song TJ, Eum J, Park DH, Lee SS, Seo DW, Lee SK. Oh HC, et al. J Gastroenterol Hepatol. 2010 Dec;25(12):1831-7. doi: 10.1111/j.1440-1746.2010.06411.x. J Gastroenterol Hepatol. 2010. PMID: 21091993 - Primary sclerosing cholangitis and malignancy.
Boberg KM, Lind GE. Boberg KM, et al. Best Pract Res Clin Gastroenterol. 2011 Dec;25(6):753-64. doi: 10.1016/j.bpg.2011.10.002. Best Pract Res Clin Gastroenterol. 2011. PMID: 22117640 Review. - A localized primary sclerosing cholangitis preoperatively diagnosed as hilar cholangiocarcinoma; report of a case.
Kojima T, Shimura T, Takahashi M, Haga N, Hashimoto S, Fukuda T, Kuwano H. Kojima T, et al. Hepatogastroenterology. 2004 Jul-Aug;51(58):961-3. Hepatogastroenterology. 2004. PMID: 15239224
Cited by
- Review of incidence and outcomes of treatment of cholangiocarcinoma in patients with primary sclerosing cholangitis.
Saffioti F, Mavroeidis VK. Saffioti F, et al. World J Gastrointest Oncol. 2021 Oct 15;13(10):1336-1366. doi: 10.4251/wjgo.v13.i10.1336. World J Gastrointest Oncol. 2021. PMID: 34721770 Free PMC article. Review. - Primary sclerosing cholangitis: outcome of patients undergoing restorative proctocolecetomy for ulcerative colitis.
Lepistö A, Kivistö S, Kivisaari L, Arola J, Järvinen HJ. Lepistö A, et al. Int J Colorectal Dis. 2009 Oct;24(10):1169-74. doi: 10.1007/s00384-009-0773-4. Epub 2009 Jul 28. Int J Colorectal Dis. 2009. PMID: 19636573 - Liver fluke induces cholangiocarcinoma.
Sripa B, Kaewkes S, Sithithaworn P, Mairiang E, Laha T, Smout M, Pairojkul C, Bhudhisawasdi V, Tesana S, Thinkamrop B, Bethony JM, Loukas A, Brindley PJ. Sripa B, et al. PLoS Med. 2007 Jul;4(7):e201. doi: 10.1371/journal.pmed.0040201. PLoS Med. 2007. PMID: 17622191 Free PMC article. Review. - Ultrasensitive detection of KRAS2 mutations in bile and serum from patients with biliary tract carcinoma using LigAmp technology.
Shi C, Chandrasekaran A, Thuluvath PJ, Karikari C, Argani P, Goggins M, Maitra A, Eshleman JR. Shi C, et al. J Mol Diagn. 2009 Nov;11(6):583-9. doi: 10.2353/jmoldx.2009.090061. Epub 2009 Oct 8. J Mol Diagn. 2009. PMID: 19815696 Free PMC article. - Follicular cholangitis associated with focal biliary stricture treated with left hepatectomy after 8 years of follow-up: A rare case report.
Saito R, Fukuda T, Amano H, Nakahara M, Yoshida M, Yamaki M, Hanada K, Yonehara S, Noriyuki T. Saito R, et al. Mol Clin Oncol. 2016 Jan;4(1):114-118. doi: 10.3892/mco.2015.659. Epub 2015 Oct 16. Mol Clin Oncol. 2016. PMID: 26870368 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Medical