Hilar Cholangiocarcinoma

If your healthcare provider thinks you may have hilar cholangiocarcinoma, they’ll do a physical examination that focuses on your abdomen (belly). They’ll look for signs of fluid buildup, lumps or tenderness in your belly. They’ll examine your skin and the whites of your eyes for jaundice.

Your provider may do blood tests, imaging tests and tests that allow them to see inside your body to check on what’s happening to your bile ducts. They may do genetic testing to look for specific genetic mutations.

Blood tests

Blood tests may include:

• Tumor markers: These tests check for substances in your blood that may be a sign of Klatskin tumor. For example, they may test the level of carbohydrate antigen (CA) 19-9. High levels of CA 19-9 may be a sign of the condition.
• Liver function tests: These may include bilirubin tests and high liver enzyme tests.

Imaging tests

Some imaging tests are also a way to obtain tissue for review by a medical pathologist. These may include:

• Magnetic resonance imaging (MRI).
• Endoscopic retrograde cholangiopancreatography (ERCP).
• Magnetic resonance cholangiopancreatography (MRCP).

Stages

If you have hilar cholangiocarcinoma, your provider will use cancer staging information to plan your treatment and prognosis, or what you can expect after treatment.

Cancer stages are classified by tumor size (T), whether cancer is in your lymph nodes (N) and if it’s metastasized (M). Providers may also consider cancer grade, which is how cancerous cells appear when viewed under a microscope. Klatskin tumor stages are:

• Stage 0: The tumor is in the inner layers of your bile duct, but it hasn’t spread into deeper layers, your lymph nodes or other areas of your body.
• Stage I: There’s cancer in your bile duct wall, but it hasn’t spread outside your bile duct.
• Stage II: The tumor has spread to nearby fatty tissue or into nearby liver tissue.
• Stage IIIA:: There’s cancer spreading into the branches on one side (left or right) of your liver’s main blood vessels.
• Stage IIIB: The tumor has spread to both sides of the main blood vessels in your liver or into other bile ducts on one side of your liver and a main blood vessel on the other side.
• Stage IIIC: Cancer is in one to three nearby lymph nodes.
• Stage IVA: The tumor has spread to four or more lymph nodes.
• Stage IVB: Cancer is now in your lungs, bones or more distant parts of your liver.