Editing Cholangiocarcinoma (section)

== '''Pathophysiology''' ==

* >90% are adenocarcinoma, with most of the remainder SCCs
* Graded as well, moderately or poorly-differentiated

=== Morphological subtypes: ===

** '''Sclerosing/periductal infiltrating''' - most common (90%), tends to be proximal ducts/hilar area, tends to track along nerves/ducts. Causes peri-ductal fibrosis in a concentric pattern.
** '''Nodular/mass-forming''' - firm, irregular nodules based in the duct wall that project into bile duct lumen, more distal cancers. Resectability and cure rates are very low.
** '''Papillary/intra-ductal''' - polypoid intra-ductal lesion, soft, less peri-ductal fibrosis, higher resectability rate, better prognosis, more distal cancers.

=== Metastatic spread ===

** Intra-hepatic spread is common
** Vascular involvement can occur early