Extrahepatic Cholangiocarcinoma: Carcinoma of the Middle and Distal Common Bile Duct (Middle and Lower Bile Duct Carcinomas)

ICD-O code biliary-type adenocarcinoma 8140/3
  • Arthur ZimmermannEmail author
Reference work entry


Cholangiocarcinomas of the distal bile duct system are conventionally defined as neoplasms located between the cystic duct entry and the end of the common bile duct in the ampullary region (infrahilar cancers). Cancers arising in a segment just distal to the cystic duct entry are sometimes classified as tumors of the duct mid-region, due to their rather distinct growth pattern (middle duct cancer), but middle and distal cancers are put together into one category by other authors. Japanese authors identified two infrahilar tumor groups and denote middle carcinomas by the abbreviation Bm and distal carcinomas by Bi. Distal-most forms of cholangiocarcinoma may be difficult to distinguish from periampullary carcinomas. Infrahilar variants of extrahepatic cholangiocarcinoma account for 20–30 % of all bile duct carcinomas, but incidence rates vary considerably among different regions of the world, due to varying prevalence of etiologic factors such as stone disease and liver fluke infestation. Macroscopically, infrahilar cholangiocarcinomas display nodular stenosing masses, masses with a tubular configuration, ulcerated tumors, diffusely growing tumors, and exophytic growths, the latter predominating in distal-most lesions.


Bile Duct Common Bile Duct Perineural Invasion Extrahepatic Bile Duct Signet Ring Cell Carcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.University of BernBernSwitzerland

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