A 70-year-old male presented to the OPD with progressive jaundice for 6 weeks, fever, pruritis along with abdominal pain and significant weight loss. Lab findings reveal, Total S. bilirubin - 22 mg/dL Minimally elevated SGOT/SGPT Increased alkaline phosphatase CT abdomen was done along with ERCP. What is the most common site of this pathology: -

This is a case of Cholangiocarcinoma. CT scan shows dilated intrahepatic biliary ducts. Cholangiocarcinoma is a malignant tumor arising from cholangiocytes in the biliary tree. It tends to have a poor prognosis and high morbidity. Most common presentation - Painless jaundice > Pruritis > Abdominal pain, weight loss and fever. Most common site - Hilum > Distal CBD > Intrahepatic bile ducts.