Case 24:   Cholangiocarcinoma

Diagnostic Category:

Clinical Presentation:

61 year old man with 1 year of epigastric pain and fullness.

CT: Mass-like, with central fibrotic enhancement and capsular retraction

Imaging Findings:

Multiphase CT reveals a left hepatic, biopsy confirmed cholangiocarcinoma. Mass is peripherally vascular with delayed washout and demonstrates typical centrally pronounced fibrotic enhancement. Also note typical capsular retraction (arrow) due to the fibrotic central tumor portions causing volume loss of the left lobe despite the presence of the large mass. Typical for other, more hypovascular cholangiocarcinomas is the reversed pattern of delayed fibrotic enhancement peripherally.