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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Cholangiocarcinoma On CT Scan

                                        Doctor my grand mother has a problem,she has been admitted in the square hospitals in bangladesh.doctor suggests us to do the CT scan and Ultrasono graphy.We have done the tests successfully and the report came wrong to the the doctor.they thought that it is cancer.but we are not satisfied with their decisions.tye report came in the CT is-cholangiocarcinoma/metatases and the ultra sono graphy report is-Multiple sists.plz advice me what we do in future?                         
Wed, 2 Sep 2015
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General Surgeon 's  Response
Hello! I've read your your concerns, i will try to breakdown systematically the answer to your queries.

Your work-ups revealed different problems with totally different management.

First, CT scan showed cholangiocarcinoma with metastasis, usually for cholangiocarcinoma with still resectable and is detected early (without metastasis) the treatment will be surgery. However, in your mother's case, you indicated that there is metastasis, I will assume that the metastasis is in the liver (most common site), the treatment for advanced cholangiocarcinoma is chemotherapy and biliary drainage (if there are sysmptoms of biliary obstruction--yellowing of skin, tea-colored urine, acholic stools). If I was the treating surgeon, I will request additional tests-- liver function, tumor markers, complete blood count.

Second, let's discussed the ultrasonography result-- it revealed several cysts. Cysts are commonly non-cancerous, they are fluid filled masses, commonly containing bile. The treatment is observation for small cysts, if the size is more than 5cm, the risk of rupture is high, hence, unroofing of cyst is suggested.

For now, it is really necessary to know the nature of the disease, since they have very different treatments pathways and course of disease.

I hope your mother gets well soon!
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Suggest Treatment For Cholangiocarcinoma On CT Scan

Hello! I ve read your your concerns, i will try to breakdown systematically the answer to your queries. Your work-ups revealed different problems with totally different management. First, CT scan showed cholangiocarcinoma with metastasis, usually for cholangiocarcinoma with still resectable and is detected early (without metastasis) the treatment will be surgery. However, in your mother s case, you indicated that there is metastasis, I will assume that the metastasis is in the liver (most common site), the treatment for advanced cholangiocarcinoma is chemotherapy and biliary drainage (if there are sysmptoms of biliary obstruction--yellowing of skin, tea-colored urine, acholic stools). If I was the treating surgeon, I will request additional tests-- liver function, tumor markers, complete blood count. Second, let s discussed the ultrasonography result-- it revealed several cysts. Cysts are commonly non-cancerous, they are fluid filled masses, commonly containing bile. The treatment is observation for small cysts, if the size is more than 5cm, the risk of rupture is high, hence, unroofing of cyst is suggested. For now, it is really necessary to know the nature of the disease, since they have very different treatments pathways and course of disease. I hope your mother gets well soon!