• Marcelo Salinas, Daniela Simian, Laura Carreño, Máximo Cattaneo, Álvaro Urzúa, Alex Sauré, Hanns Lembach, Jaime Castillo, Juan C Díaz, and Jaime Poniachik.
• Departamento de Medicina, Hospital Clínico, Universidad de Chile, Santiago, Chile.
• Rev Med Chil. 2022 Nov 1; 150 (11): 143114371431-1437.

BackgroundCholangiocarcinoma (CCA) is a primary hepatic tumor, frequently found in patients with liver cirrhosis and biliary tract diseases. Its varieties include isolated CCA or "combined hepatocellular-cholangiocarcinoma" (cHCC-CCA). The latter is uncommon, with poorly defined diagnostic criteria and natural history.AimTo characterize patients with cirrhosis with a pathological diagnosis of CCA and cHCC-CCA.Material And MethodsForty-nine liver biopsies with a pathological diagnosis of CCA were reviewed. The clinical records of patients were reviewed to fetch demographic variables, etiology of cirrhosis and clinical presentation.ResultsEight of the 49 patients had cirrhosis (16% of CCA biopsies reviewed). Their median age was 64 (27-71) years and five were females. Four patients had CCA, three patients cHCC-CCA and one had a bifocal tumor. Patients in the CCA group were more commonly symptomatic. Alpha-fetoprotein and CA 19-9 levels were elevated in one of eight and four of six patients, respectively. Within 12 months from diagnosis, five of eight patients died.ConclusionsIn most of these cases, the diagnosis of cHCC-CCA and CCA was made in the liver explant study without previous imaging diagnosis. This reinforces the usefulness of the histological study, in specific cases, prior to liver transplantation and emphasizes the importance of systematic explant exploration in these cases.

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