Biliary Cancer
Biliary cancer refers to malignant tumors that arise from the bile ducts, either inside the liver (intrahepatic) or outside the liver (extrahepatic). This group of cancers is also known as cholangiocarcinoma. Because the bile ducts are narrow and deep within the abdomen, symptoms often develop gradually and may include jaundice, itching, abdominal pain, or unexplained weight loss. Imaging plays a key role in detecting blockages, narrowing, or masses involving the biliary tree.
What is it?
Biliary cancer (cholangiocarcinoma) develops when cells lining the bile ducts grow abnormally and form a tumor. The bile ducts carry bile from the liver and gallbladder to the small intestine to help digest fats. Tumors in this system can block the flow of bile, leading to jaundice and other symptoms. The cancer may develop anywhere along the biliary tree, including the small ducts within the liver, the larger ducts outside the liver, or the region where the bile duct meets the pancreas.
Risk factors include chronic inflammation of the bile ducts, primary sclerosing cholangitis, certain congenital biliary abnormalities, parasitic infections (in some regions), gallstones, and cirrhosis. Imaging helps identify whether a stricture is smooth and benign or irregular and suspicious for cancer, and whether the tumor has spread to nearby structures or lymph nodes.
Important to Know
Because early biliary cancer may cause few symptoms, many cases are diagnosed only after jaundice or other signs of bile duct obstruction appear. CT and MRI/MRCP are crucial for mapping the tumor’s extent and determining whether surgery is possible. In some cases, ERCP or percutaneous procedures are used to place stents to relieve obstruction and improve symptoms.
Red flags include sudden or worsening jaundice, severe abdominal pain, fever, chills, or confusion—these may signal infection, obstruction, or advanced disease and require urgent care. Treatment varies based on tumor location and spread, and may involve a combination of surgery, chemotherapy, radiation, immunotherapy, or targeted therapies. Follow-up imaging is important for monitoring response and detecting recurrence.