Cholangiocarcinoma – new concepts and classifications

MDCT Diagnosis of Perineural Invasion Involving the Celiac Plexus in Intrahepatic Cholangiocarcinoma: Preliminary Observations and Clinical Implications

“…Given the particularly poor prognosis of intrahepatic cholangiocarcinoma when perineural invasion is present [1,3,8], the preoperative diagnosis of perineural invasion by MDCT may be helpful in patients with intrahepatic cholangiocarcinoma for staging, determination of prognosis, and treatment planning and may assist with decisions regarding neoadjuvant therapy, adjuvant therapy, and hepatic resection. Further to this, we speculate that soft-tissue infiltration around the celiac artery on MDCT could be biopsied before undertaking a major resection, either via endoscopic ultrasound guidance or at the time of laparotomy, providing tissue with which to further evaluate the presence or absence of perineural invasion.…”