Cholangiocarcinoma: Etiology, Pathogenesis, Diagnosis, and Management

Cholangiocarcinoma (CCA) is leading a neoplasm melanoma of the biliary duct system accounting for 3% of gastrointestinal tumors [1]. It is the subordinate most extensive primary hepatic malignancy, representing 10–25% of primary hepatic malignancies worldwide [2]. CCA infrequently occurs earlier than the age of 40; the typical age at presentation is the seventh decade of life. Men have a higher incidence of CCA than women with ratios of 1:1.2–1.5. The incidence of CCA varies significantly by geographic area secondary to variations in risk factors. CCA is deadly due to its ability to recur, metastasize, late diagnosis, and drug-refractory nature. While the incidence of ICC is rising, the occurrence of ECC is trending down suggesting that different risk factors may be involved. The prognosis of CCA is poor; therefore, the mortality and prevalence rates are parallel. Even though there are recognized risk factors for the development of CCA, most patients do not have an identifiable risk aside from age [3].