Dr. Collisson on the Difficulty of Diagnosing Cholangiocarcinoma

Eric A. Collisson, MD, associate professor, Department of Medicine, University of California, San Francisco Helen Diller Comprehensive Cancer Center, discusses the difficulty of diagnosing cholangiocarinoma.

It is difficult to diagnose patients with cholangiocarcinoma, states Collisson. Most oncologists and many clinicians are familiar with liver tumors that are detected radiographically. The correct assumption most of the time, says Collisson, is that it’s a metastasis. It can be difficult to rule out carcinoma from another source in the body that has traveled to the liver versus what is termed a "diagnosis of exclusion." Isolating the tumor’s origin from the biliary tract system is increasingly done by sophisticated pathology approaches.

The problem is that cells are quite infrequent and difficult to obtain. Pathologists are tasked with diagnosing the disease efficiently, while leaving adequate tissue for other analyses such as FGFR2. Collisson says this is a rationing strategy.