Cholangiocarcinoma in pregnancy: A case report

Abstract

A 32-year-old pregnant woman underwent laparotomy for suspected intra-abdominal mass lesion obstructing the biliary tree. Imaging studies revealed a mass in the fourth segment of the liver. Microscopic examination of the biopsy revealed a cholangiocarcinoma. The clinical course of the malignancy was worsened by her gravid state.

Liver Tumor in Pregnancy

“…Surgery, through liver transplantation and hepatic resection, is considered the only curative treatment and can be performed safely during pregnancy. Studies of hepatic volume are very useful to calculate residual volume, although the long-term results fall still below the expectations [1][2][3][4][5][6].…”

“…Historically, its evaluation and treatment required the arbitrary division of the bile duct in thirds, depending on the location of the obstruction [1,2]. The incidence of malignant liver tumors in pregnant women is exceptional, and its origin in intrahepatic bile ducts is even rarer, with 80-90% of hepatic tumors diagnosed during pregnancy representing hepatocellular carcinoma [3,4].…”

“…Very few cases of worsening of cholangiocarcinoma in pregnancy have been reported in the literature. In fact, the high concentration of estrogen and the suppression of the immune system derived from pregnancy can aggravate the preexisting liver injury [2][3][4][5].…”

Administration of Gemcitabine for Metastatic Adenocarcinoma during Pregnancy: A Case Report and Review of the Literature

“…Biliary tract cancers during pregnancy have rarely been described in the literature. None of the five case reports available [22][23][24][25][26] mentions the application of chemotherapy.…”

Recurrent Cholangiocarcinoma in Pregnancy: A Case Report

“…There are only seven published cases of cholangiocarcinoma in an obstetrical patient, all are cases of primary cholangiocarcinoma. 1 2 3 4 5 6 7 There is limited data regarding the recurrence of cholangiocarcinoma in pregnancy and pregnancy outcomes in the presence of recurrent disease. We discuss the management considerations inherent to this complex clinical scenario including metastatic disease severity, ethical considerations, and palliative care treatment options.…”