What is the difference between bile duct cancer and liver cancer

What is the difference between bile duct cancer and liver cancer? We all know that both are cancers, but they are different in name and nature. Many people know the difference, but cannot tell them apart. So, today I will introduce the difference between bile duct cancer and liver cancer.

About Cholangiocarcinoma:

Cholangiocarcinoma refers to a malignant tumor of the extrahepatic bile duct that originates from the confluence of the left and right hepatic ducts to the lower end of the common bile duct. Cholangiocarcinoma can be divided into three types: hilar cholangiocarcinoma or upper cholangiocarcinoma, middle cholangiocarcinoma, and lower cholangiocarcinoma. Primary cholangiocarcinoma is rare, accounting for 0.01% to 0.46% of ordinary autopsies, 2% of autopsies of tumor patients, and 0.3% to 1.8% of biliary surgeries. In Europe and the United States, gallbladder cancer is 1.5 to 5 times that of bile duct cancer, while Japanese data show that bile duct cancer is more common than gallbladder cancer. The male to female ratio is about 1.5 to 3.0. The age of onset is mostly 50 to 70 years old, but it can also be seen in young people.

Progressive obstructive jaundice is the main symptom of cholangiocarcinoma (80% to 90%). Other common symptoms include weight loss, emaciation, enlarged liver, and sometimes palpable enlarged gallbladder.

The main clinical manifestations are progressive jaundice, loss of appetite, weight loss, itching, etc. accompanied by upper abdominal discomfort. If combined with gallstones and biliary infection, there may be chills, fever, paroxysmal abdominal pain and dull pain. If the hepatic duct cancer is located on one side, it is often asymptomatic at first. When it affects the opening of the contralateral hepatic duct, obstructive jaundice will occur.

If the middle part of the bile duct cancer is not accompanied by gallstones and infection, it is usually painless and progressive obstructive jaundice. Jaundice usually progresses quickly and does not fluctuate. Examination shows that the liver is enlarged and hard, and the gallbladder is not enlarged. If it is the lower part of the common bile duct, an enlarged gallbladder can be palpated. If the tumor ruptures and bleeds, there may be symptoms such as black stools or positive fecal occult blood test, anemia, etc.

About Liver Cancer:

Liver cancer refers to cancer that occurs in the liver. If the cancer is caused by cells in the liver, it is called "primary liver cancer"; liver malignant tumors formed by cancer in other organs of the body metastasizing to the liver are called secondary liver cancer, also known as "metastatic liver cancer". Various mesodermal tumors that infiltrate the liver are usually called sarcoma liver infiltration and are not included in secondary liver cancer. Primary liver cancer can be divided into "hepatocellular type", "cholangiocyte type" and "mixed type" according to histological classification.

Affected population: This disease can occur at any age, with the highest incidence between 40 and 49 years old, and the male to female ratio is 2 to 5:1.

Most liver cancer nodules are spherical in appearance, with irregular borders, and "satellite nodules" may appear around the tumor. Cancer nodules near the capsule in the periphery of the liver generally protrude from the surface but have no central depression. The cross-section of cancer nodules is mostly grayish white, some may be yellow due to fatty degeneration or necrosis, green due to containing more bile, or reddish brown due to bleeding. Hemorrhagic necrosis is more common in the central part of large nodules. The texture of cancer nodules is related to the histological type. The cross-section of solid cancer is homogeneous, smooth and soft; the cross-section of beam-shaped cancer is dry and granular; and the texture of cholangiocarcinoma is dense due to its rich collagen fibers. The volume of liver cancer increases significantly, and the weight can reach 2000-3000g. The bulky liver cancer without cirrhosis is even larger, and the weight can reach more than 7000g. Most liver cancers are accompanied by macronodular or mixed cirrhosis, and cancer thrombi can be seen in some portal veins and hepatic vein cavities.

Symptoms: The clinical symptoms of primary liver cancer are more obvious, with symptoms such as progressive weight loss, fatigue, anorexia, and pain in the liver area, and the disease progresses rapidly. Secondary liver cancer often presents with symptoms caused by extrahepatic primary tumors as the main manifestations, the clinical manifestations are often milder, and the disease progresses slowly.

I believe that through the above comparison, everyone can distinguish between bile duct cancer and liver cancer.