Cholangiocarcinoma in pregnancy: a case report

Authors

  • Chun-Yee CHOW
  • Choi-Wah KONG
  • William WK TO

DOI:

https://doi.org/10.12809/hkjgom.21.2.01

Abstract

A 35-year-old pregnant woman presented at 19 weeks of gestation with epigastric pain and mildly elevated alanine transaminase level. She subsequently developed acute cholangitis, with deteriorated liver function. Imaging revealed features of cholangiocarcinoma. Termination of pregnancy was performed at 22 weeks of gestation to facilitate maternal treatment. She underwent hepatectomy, followed by multiple courses of chemotherapy and immunotherapy. However, she died from hepatorenal failure with hepatic encephalopathy 1 year later. Cholangiocarcinoma in pregnancy is rare. Although it is a differential diagnosis of deranged liver function in pregnancy, a precise diagnosis can be challenging as the presenting signs and symptoms are not obvious.

References

Banales JM, Cardinale V, Carpino G, et al. Expert consensus document: cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA). Nat Rev Gastroenterol Hepatol 2016;13:261-80.

Banales JM, Marin JJG, Lamarca A, et al. Cholangiocarcinoma 2020: the next horizon in mechanisms and management. Nat Rev Gastroenterol Hepatol 2020;17:557-88.

Khan SA, Tavolari S, Brandi G. Cholangiocarcinoma: epidemiology and risk factors. Liver Int 2019;39(Suppl 1):19-31.

Wu W, Qian X, Huang Y, Hong Q. A review of the control of clonorchiasis sinensis and Taenia solium taeniasis/cysticercosis in China. Parasitol Res 2012;111:1879-84.

Shin HR, Oh JK, Masuyer E, et al. Epidemiology of cholangiocarcinoma: an update focusing on risk factors. Cancer Sci 2010;101:579-85.

Das S, Job M, Kodiatte T, Iyadurai R. Atypical presentation of intrahepatic cholangiocarcinoma: fever and ascites in a postpartum lady. J Family Med Prim Care 2019;8:3748-51.

Francis AP, Chang M, Dolin CD, Chervenak J, Cardonick E. Recurrent cholangiocarcinoma in pregnancy: a case report. AJP Rep 2018;8:e261-e263.

Pencovich N, Younis M, Lessing Y, et al. Major liver resection in pregnancy: three cases with different etiologies and review of the literature. J Matern Fetal Neonatal Med 2019;32:203-11.

Qasrawi A, Abughanimeh O, Abu Ghanimeh M, Arora-Elder S, Yousef O, Tamimi T. Intrahepatic cholangiocarcinoma masquerading as acute fatty liver of pregnancy: a case report and review of the literature. Case Reports Hepatol 2018;2018:6939747.

Gerli S, Favilli A, Giordano C, Donini A, Di Renzo GC. Mixed hepatocellular carcinoma and cholangiocarcinoma during pregnancy: a case report. Eur J Obstet Gynecol Reprod Biol 2015;187:76-7.

Wiesweg M, Aydin S, Koeninger A, et al. Administration of gemcitabine for metastatic adenocarcinoma during pregnancy: a case report and review of the literature. AJP Rep 2014;4:17-22.

Stone S, Girling JC. Deranged liver function tests in pregnancy: the importance of postnatal follow-up. Obstet Med 2009;2:32-3.

Sadoon S, Hodgett S. Unusual cause of itching in a pregnancy (cholangiocarcinoma). J Obstet Gynaecol 2008;28:230-1.

Marasinghe JP, Karunananda SA, Angulo P. Cholangiocarcinoma in pregnancy: a case report. J Obstet Gynaecol Res 2008;34:635-7.

Balderston KD, Tewari K, Azizi F, Yu JK. Intrahepatic cholangiocarcinoma masquerading as the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) in pregnancy: case report. Am J Obstet Gynecol 1998;179:823-4.

Zelissen PM, van Hattum J. A young woman with a liver tumor and hypercalcemia. Ned Tijdschr Geneeskd 1986;130:1705-7.

Nakamoto SK, van Sonnenberg E. Cholangiocarcinoma in pregnancy: the contributions of ultrasound-guided interventional techniques. J Ultrasound Med 1985;4:557-9.

Devoe LD, Moossa AR, Levin B. Pregnancy complicated by extrahepatic biliary tract carcinoma. A case report. J Reprod Med 1983;28:153-5.

Purtilo DT, Clark JV, Williams R. Primary hepatic malignancy in pregnant women. Am J Obstet Gynecol 1975;121:41-4.

Walker I, Chappell LC, Williamson C. Abnormal liver function tests in pregnancy. BMJ 2013;347:f6055.

Khan SA, Davidson BR, Goldin RD, et al. Guidelines for the diagnosis and treatment of cholangiocarcinoma: an update. Gut 2012;61:1657-69.

Wong HY, Tan JY, Lim CC. Abnormal liver function tests in the symptomatic pregnant patient: the local experience in Singapore. Ann Acad Med Singap 2004;33:204-8.

Nelson-Piercy C. Handbook of Obstetrics Medicine. Boca Raton: CRC Press; 2015:217-23.

Cillo U, Fondevila C, Donadon M, et al. Surgery for cholangiocarcinoma. Liver Int 2019;39(Suppl 1):143-55.

Albright CM, Wenstrom KD. Malignancies in pregnancy. Best Pract Res Clin Obstet Gynaecol 2016;33:2-18.

ESMO E-learning: Cancer management during pregnancy. Good science better medicine best practice. European Society for Medical Oncology. Available from https://oncologypro.esmo.org/content/download/38057/749465/file/cancerpregnancy-Pavlidis-Boussios-Pentheroudakis.pdf. Accessed 18 April 2021.

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Published

2023-04-06

How to Cite

1.
CHOW C-Y, KONG C-W, TO WW. Cholangiocarcinoma in pregnancy: a case report. Hong Kong J Gynaecol Obstet Midwifery [Internet]. 2023 Apr. 6 [cited 2024 Dec. 22];21(2). Available from: https://hkjgom.org/home/article/view/301

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Case Report

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