Challenges in Cholangiocarcinoma, Misdiagnosis with Hydatid Cyst Rupture: A Review
Main Article Content
Abstract
Cholangiocarcinoma, an adenocarcinoma arising from the epithelium of biliary ducts, is considered the second most common hepatic malignancy after hepatocellular carcinoma with increasing incidence over the past 3 decades. Many imaging modalities with correlation to clinical presentation are used for the diagnosis and staging of cholangiocarcinoma. However, the diagnosis of cholangiocarcinoma is still challenging due to the presence of some benign and malignant conditions that mimic the clinical presentation and radiological findings of this disease. One of those mimics is the condition of intrabiliary hydatid cyst rupture which can cause biliary obstructive symptoms over weeks with radiological findings that may be indistinguishable from those of cholangiocarcinoma and specifically klatskin tumor when found at the bifurcation of the common hepatic duct. In such a confusing situation, the correct preoperative diagnosis and potential treatment of the disease could both be made possible using Endoscopic Retrograde Cholangiopancreatography avoiding unrequired surgical interventions.
Keywords:
Cholangiocarcinoma, Hydatid disease, Hydatid cyst rupture
Article Details
How to Cite
HAMDAN, Ali et al.
Challenges in Cholangiocarcinoma, Misdiagnosis with Hydatid Cyst Rupture: A Review.
Medical Research Archives, [S.l.], v. 11, n. 11, nov. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4636>. Date accessed: 16 may 2024.
doi: https://doi.org/10.18103/mra.v11i11.4636.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Patel T. Cholangiocarcinoma--controversies and challenges. Nat Rev Gastroenterol Hepatol. 2011;8(4):189-200. doi:10.1038/nrgastro.2011.20
2. Krasinskas AM. Cholangiocarcinoma. Surg Pathol Clin. 2018;11(2):403-429. doi:10.1016/j.path.2018.02.005
3. Bergquist A, von Seth E. Epidemiology of cholangiocarcinoma. Best Pract Res Clin Gastroenterol. 2015;29(2):221-232. doi:10.1016/j.bpg.2015.02.003
4. Rizvi S, Gores GJ. Pathogenesis, diagnosis, and management of cholangiocarcinoma. Gastroenterology. 2013;145(6):1215-1229. doi:10.1053/j.gastro.2013.10.013
5. Khan SA, Davidson BR, Goldin RD, et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: an update. Gut. 2012;61(12):1657-1669. doi:10.1136/gutjnl-2011-301748
6. Everhart JE, Ruhl CE. Burden of digestive diseases in the United States Part III: Liver, biliary tract, and pancreas. Gastroenterology. 2009;136(4):1134-1144. doi:10.1053/j.gastro.2009.02.038
7. Tyson GL, El-Serag HB. Risk factors for cholangiocarcinoma. Hepatology. 2011;54(1):173-184. doi:10.1002/hep.24351
8. Forner A, Vidili G, Rengo M, Bujanda L, Ponz-Sarvisé M, Lamarca A. Clinical presentation, diagnosis and staging of cholangiocarcinoma. Liver Int. 2019;39 Suppl 1:98-107. doi:10.1111/liv.14086
9. Cardinale V, Bragazzi MC, Carpino G, Matteo SD, Overi D, Nevi L, Gaudio E, Alvaro D. Intrahepatic cholangiocarcinoma: review and update. Hepatoma Research. 2018; 4: 20. http://dx.doi.org/10.20517/2394-5079.2018.46
10. Kovač JD, Janković A, Đikić-Rom A, Grubor N, Antić A, Dugalić V. Imaging Spectrum of Intrahepatic Mass-Forming Cholangiocarcinoma and Its Mimickers: How to Differentiate Them Using MRI. Curr Oncol. 2022;29(2):698-723. Published 2022 Jan 30. doi:10.3390/curroncol29020061
11. Alimoradi M, El-Helou E, Sabra H, Hani P, Wakim R. A non-klatskin tumor: A case report and review of intrabiliary hydatid cyst rupture. Int J Surg Case Rep. 2020;77:260-263. doi:10.1016/j.ijscr.2020.10.123.
12. Khan SA, Davidson BR, Goldin RD, et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: an update. Gut. 2012;61(12):1657-1669. doi:10.1136/gutjnl-2011-301748
13. Khan SA, Davidson BR, Goldin R, et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: consensus document. Gut. 2002;51 Suppl 6(Suppl 6):VI1-VI9. doi:10.1136/gut.51.suppl_6.vi1
14. Qin XL, Wang ZR, Shi JS, Lu M, Wang L, He QR. Utility of serum CA19-9 in diagnosis of cholangiocarcinoma: in comparison with CEA. World J Gastroenterol. 2004;10(3):427-432. doi:10.3748/wjg.v10.i3.427
15. Shin DW, Moon S-H, Kim JH. Diagnosis of Cholangiocarcinoma. Diagnostics. 2023; 13(2):233. https://doi.org/10.3390/diagnostics13020233
16. Gores GJ. Cholangiocarcinoma: current concepts and insights. Hepatology. 2003;37(5):961-969. doi:10.1053/jhep.2003.50200
17. Van Beers BE. Diagnosis of cholangiocarcinoma. HPB (Oxford). 2008;10(2):87-93. doi:10.1080/13651820801992716
18. Shin DW, Moon S-H, Kim JH. Diagnosis of Cholangiocarcinoma. Diagnostics. 2023; 13(2):233. https://doi.org/10.3390/diagnostics13020233
19. Anderson CD, Rice MH, Pinson CW, Chapman WC, Chari RS, Delbeke D. Fluorodeoxyglucose PET imaging in the evaluation of gallbladder carcinoma and cholangiocarcinoma. J Gastrointest Surg. 2004;8(1):90-97. doi:10.1016/j.gassur.2003.10.003
20. Fritscher-Ravens A, Bohuslavizki KH, Broering DC, et al. FDG PET in the diagnosis of hilar cholangiocarcinoma. Nucl Med Commun. 2001;22(12):1277-1285. doi:10.1097/00006231-200112000-00002
21. NIH state-of-the-science statement on endoscopic retrograde cholangiopancreatography (ERCP) for diagnosis and therapy. NIH Consens State Sci Statements. 2002;19(1):1-26.
22. Abu-Hamda EM, Baron TH. Endoscopic management of cholangiocarcinoma. Semin Liver Dis. 2004;24(2):165-175. doi:10.1055/s-2004-828893
23. Inui K, Miyoshi H. Cholangiocarcinoma and intraductal sonography. Gastrointest Endosc Clin N Am. 2005;15(1):143-x. doi:10.1016/j.giec.2004.07.006
24. Taratuto AL, Venturiello SM. Echinococcosis. Brain Pathol. 1997;7(1):673-679. doi:10.1111/j.1750-3639.1997.tb01082.x
25. Filippou D, Tselepis D, Filippou G, Papadopoulos V. Advances in liver echinococcosis: diagnosis and treatment. Clin Gastroenterol Hepatol. 2007;5(2):152-159. doi:10.1016/j.cgh.2006.08.017
26. Lahfidi A, Traore WM, Diallo ID, Abdellaoui M, El Fenni J, Saouab R. Atypical manifestation of a fistula between a hydatid cyst of a liver and a gallbladder: A case report. Radiol Case Rep. 2022;17(10):3735-3738. Published 2022 Aug 4. doi:10.1016/j.radcr.2022.07.044
27. Pohnan R, Ryska M, Hytych V, Matej R, Hrabal P, Pudil J. Echinococcosis mimicking liver malignancy: A case report. Int J Surg Case Rep. 2017;36:55-58. doi:10.1016/j.ijscr.2017.04.032
28. Brunetti E, Kern P, Vuitton DA; Writing Panel for the WHO-IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010;114(1):1-16. doi:10.1016/j.actatropica.2009.11.001
29. Turgut AT, Akhan O, Bhatt S, Dogra VS. Sonographic spectrum of hydatid disease. Ultrasound Q. 2008;24(1):17-29. doi:10.1097/RUQ.0b013e318168f0d1
30. Avcu S, Ünal Ö, Arslan H. Intrabiliary rupture of liver hydatid cyst: a case report and review of the literature. Cases J. 2009;2:6455. Published 2009 Mar 10. doi:10.1186/1757-1626-2-6455
31. Wani I, Bhat Y, Khan N, Mir F, Nanda S, Shah OJ. Concomitant Rupture of Hydatid Cyst of Liver in Hepatic Duct and Gallbladder: Case Report. Gastroenterology Res. 2010;3(4):175-179. doi:10.4021/gr215e
32. Lewall DB, McCorkell SJ. Rupture of echinococcal cysts: diagnosis, classification, and clinical implications. AJR Am J Roentgenol. 1986;146(2):391-394. doi:10.2214/ajr.146.2.391
33. Dolay K, Akbulut S. Role of endoscopic retrograde cholangiopancreatography in the management of hepatic hydatid disease. World J Gastroenterol. 2014;20(41):15253-15261. doi:10.3748/wjg.v20.i41.15253
34. Ufuk F, Duran M. Intrabiliary Rupture of Hepatic Hydatid Cyst Leading to Biliary Obstruction, Cholangitis, and Septicemia. J Emerg Med. 2018;54(1):e15-e17. doi:10.1016/j.jemermed.2017.09.009
35. Mermi EU, Fidan N, Murat M. Focal Biliary System Obstruction and Atypical Liver Mass: Intrabiliary Ruptured Cyst Hydatid Case Report. Pol J Radiol. 2017;82:110-113. Published 2017 Feb 25. doi:10.12659/PJR.899073
36. Kumar R, Reddy SN, Thulkar S. Intrabiliary rupture of hydatid cyst: diagnosis with MRI and hepatobiliary isotope study. Br J Radiol. 2002;75(891):271-274. doi:10.1259/bjr.75.891.750271
37. Kovač JD, Janković A, Đikić-Rom A, Grubor N, Antić A, Dugalić V. Imaging Spectrum of Intrahepatic Mass-Forming Cholangiocarcinoma and Its Mimickers: How to Differentiate Them Using MRI. Curr Oncol. 2022;29(2):698-723. Published 2022 Jan 30. doi:10.3390/curroncol29020061
38. Hankins JR. Management of complicated hepatic hydatid cysts. Ann Surg. 1963;158(6):1020-1034. doi:10.1097/00000658-196312000-00014
2. Krasinskas AM. Cholangiocarcinoma. Surg Pathol Clin. 2018;11(2):403-429. doi:10.1016/j.path.2018.02.005
3. Bergquist A, von Seth E. Epidemiology of cholangiocarcinoma. Best Pract Res Clin Gastroenterol. 2015;29(2):221-232. doi:10.1016/j.bpg.2015.02.003
4. Rizvi S, Gores GJ. Pathogenesis, diagnosis, and management of cholangiocarcinoma. Gastroenterology. 2013;145(6):1215-1229. doi:10.1053/j.gastro.2013.10.013
5. Khan SA, Davidson BR, Goldin RD, et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: an update. Gut. 2012;61(12):1657-1669. doi:10.1136/gutjnl-2011-301748
6. Everhart JE, Ruhl CE. Burden of digestive diseases in the United States Part III: Liver, biliary tract, and pancreas. Gastroenterology. 2009;136(4):1134-1144. doi:10.1053/j.gastro.2009.02.038
7. Tyson GL, El-Serag HB. Risk factors for cholangiocarcinoma. Hepatology. 2011;54(1):173-184. doi:10.1002/hep.24351
8. Forner A, Vidili G, Rengo M, Bujanda L, Ponz-Sarvisé M, Lamarca A. Clinical presentation, diagnosis and staging of cholangiocarcinoma. Liver Int. 2019;39 Suppl 1:98-107. doi:10.1111/liv.14086
9. Cardinale V, Bragazzi MC, Carpino G, Matteo SD, Overi D, Nevi L, Gaudio E, Alvaro D. Intrahepatic cholangiocarcinoma: review and update. Hepatoma Research. 2018; 4: 20. http://dx.doi.org/10.20517/2394-5079.2018.46
10. Kovač JD, Janković A, Đikić-Rom A, Grubor N, Antić A, Dugalić V. Imaging Spectrum of Intrahepatic Mass-Forming Cholangiocarcinoma and Its Mimickers: How to Differentiate Them Using MRI. Curr Oncol. 2022;29(2):698-723. Published 2022 Jan 30. doi:10.3390/curroncol29020061
11. Alimoradi M, El-Helou E, Sabra H, Hani P, Wakim R. A non-klatskin tumor: A case report and review of intrabiliary hydatid cyst rupture. Int J Surg Case Rep. 2020;77:260-263. doi:10.1016/j.ijscr.2020.10.123.
12. Khan SA, Davidson BR, Goldin RD, et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: an update. Gut. 2012;61(12):1657-1669. doi:10.1136/gutjnl-2011-301748
13. Khan SA, Davidson BR, Goldin R, et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: consensus document. Gut. 2002;51 Suppl 6(Suppl 6):VI1-VI9. doi:10.1136/gut.51.suppl_6.vi1
14. Qin XL, Wang ZR, Shi JS, Lu M, Wang L, He QR. Utility of serum CA19-9 in diagnosis of cholangiocarcinoma: in comparison with CEA. World J Gastroenterol. 2004;10(3):427-432. doi:10.3748/wjg.v10.i3.427
15. Shin DW, Moon S-H, Kim JH. Diagnosis of Cholangiocarcinoma. Diagnostics. 2023; 13(2):233. https://doi.org/10.3390/diagnostics13020233
16. Gores GJ. Cholangiocarcinoma: current concepts and insights. Hepatology. 2003;37(5):961-969. doi:10.1053/jhep.2003.50200
17. Van Beers BE. Diagnosis of cholangiocarcinoma. HPB (Oxford). 2008;10(2):87-93. doi:10.1080/13651820801992716
18. Shin DW, Moon S-H, Kim JH. Diagnosis of Cholangiocarcinoma. Diagnostics. 2023; 13(2):233. https://doi.org/10.3390/diagnostics13020233
19. Anderson CD, Rice MH, Pinson CW, Chapman WC, Chari RS, Delbeke D. Fluorodeoxyglucose PET imaging in the evaluation of gallbladder carcinoma and cholangiocarcinoma. J Gastrointest Surg. 2004;8(1):90-97. doi:10.1016/j.gassur.2003.10.003
20. Fritscher-Ravens A, Bohuslavizki KH, Broering DC, et al. FDG PET in the diagnosis of hilar cholangiocarcinoma. Nucl Med Commun. 2001;22(12):1277-1285. doi:10.1097/00006231-200112000-00002
21. NIH state-of-the-science statement on endoscopic retrograde cholangiopancreatography (ERCP) for diagnosis and therapy. NIH Consens State Sci Statements. 2002;19(1):1-26.
22. Abu-Hamda EM, Baron TH. Endoscopic management of cholangiocarcinoma. Semin Liver Dis. 2004;24(2):165-175. doi:10.1055/s-2004-828893
23. Inui K, Miyoshi H. Cholangiocarcinoma and intraductal sonography. Gastrointest Endosc Clin N Am. 2005;15(1):143-x. doi:10.1016/j.giec.2004.07.006
24. Taratuto AL, Venturiello SM. Echinococcosis. Brain Pathol. 1997;7(1):673-679. doi:10.1111/j.1750-3639.1997.tb01082.x
25. Filippou D, Tselepis D, Filippou G, Papadopoulos V. Advances in liver echinococcosis: diagnosis and treatment. Clin Gastroenterol Hepatol. 2007;5(2):152-159. doi:10.1016/j.cgh.2006.08.017
26. Lahfidi A, Traore WM, Diallo ID, Abdellaoui M, El Fenni J, Saouab R. Atypical manifestation of a fistula between a hydatid cyst of a liver and a gallbladder: A case report. Radiol Case Rep. 2022;17(10):3735-3738. Published 2022 Aug 4. doi:10.1016/j.radcr.2022.07.044
27. Pohnan R, Ryska M, Hytych V, Matej R, Hrabal P, Pudil J. Echinococcosis mimicking liver malignancy: A case report. Int J Surg Case Rep. 2017;36:55-58. doi:10.1016/j.ijscr.2017.04.032
28. Brunetti E, Kern P, Vuitton DA; Writing Panel for the WHO-IWGE. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010;114(1):1-16. doi:10.1016/j.actatropica.2009.11.001
29. Turgut AT, Akhan O, Bhatt S, Dogra VS. Sonographic spectrum of hydatid disease. Ultrasound Q. 2008;24(1):17-29. doi:10.1097/RUQ.0b013e318168f0d1
30. Avcu S, Ünal Ö, Arslan H. Intrabiliary rupture of liver hydatid cyst: a case report and review of the literature. Cases J. 2009;2:6455. Published 2009 Mar 10. doi:10.1186/1757-1626-2-6455
31. Wani I, Bhat Y, Khan N, Mir F, Nanda S, Shah OJ. Concomitant Rupture of Hydatid Cyst of Liver in Hepatic Duct and Gallbladder: Case Report. Gastroenterology Res. 2010;3(4):175-179. doi:10.4021/gr215e
32. Lewall DB, McCorkell SJ. Rupture of echinococcal cysts: diagnosis, classification, and clinical implications. AJR Am J Roentgenol. 1986;146(2):391-394. doi:10.2214/ajr.146.2.391
33. Dolay K, Akbulut S. Role of endoscopic retrograde cholangiopancreatography in the management of hepatic hydatid disease. World J Gastroenterol. 2014;20(41):15253-15261. doi:10.3748/wjg.v20.i41.15253
34. Ufuk F, Duran M. Intrabiliary Rupture of Hepatic Hydatid Cyst Leading to Biliary Obstruction, Cholangitis, and Septicemia. J Emerg Med. 2018;54(1):e15-e17. doi:10.1016/j.jemermed.2017.09.009
35. Mermi EU, Fidan N, Murat M. Focal Biliary System Obstruction and Atypical Liver Mass: Intrabiliary Ruptured Cyst Hydatid Case Report. Pol J Radiol. 2017;82:110-113. Published 2017 Feb 25. doi:10.12659/PJR.899073
36. Kumar R, Reddy SN, Thulkar S. Intrabiliary rupture of hydatid cyst: diagnosis with MRI and hepatobiliary isotope study. Br J Radiol. 2002;75(891):271-274. doi:10.1259/bjr.75.891.750271
37. Kovač JD, Janković A, Đikić-Rom A, Grubor N, Antić A, Dugalić V. Imaging Spectrum of Intrahepatic Mass-Forming Cholangiocarcinoma and Its Mimickers: How to Differentiate Them Using MRI. Curr Oncol. 2022;29(2):698-723. Published 2022 Jan 30. doi:10.3390/curroncol29020061
38. Hankins JR. Management of complicated hepatic hydatid cysts. Ann Surg. 1963;158(6):1020-1034. doi:10.1097/00000658-196312000-00014