Sclerosing Carcinoma of the Major Intrahepatic Bile Ducts

Primary carcinoma of the bile ducts may be extrahepatic or intrahepatic in origin. The clinical and diagnostic features of the more prevalent extrahepatic forms are well known, but considerably less information is available for the intrahepatic variety.1-5Carcinomas arising from the mucosal cells of the finer radicles of the intrahepatic biliary tree are known as cholangiomas and are usually considered to be an uncommon form of primary neoplasm of the liver.6There is another unusual type of primary carcinoma of the intrahepatic ducts which is rarer and more difficult to recognize. This form arises from the major intrahepatic ducts near the hilus. Its insidious nature, the ease with which it mimics other biliary tract disorders, and its relative inaccessibility to surgical approach are factors which have made diagnosis very difficult, and frequently impossible until autopsy.2-4 Since 1950, three patients with primary adenocarcinoma of the intrahepatic bile ducts have