LAUSR

Cholangiocarcinoma (CCA) is a hepatobiliary malignancy which arises from damaged cholangiocytes, the epithelial cells that line the biliary tree [1]. CCAs are generally categorized as intrahepatic or extrahepatic based on their anatomic location with respect to second order bile ducts [2]. The incidence of intrahepatic cholangiocarcinoma (IHCC) in the western world is approximately 1–2 per 100,000, while it is more common in East and South East Asia with an incidence of 10–71 per 100,000 [3, 4]. The typical age at presentation is the seventh decade of life, and men have a higher incidence than women [5]. The symptoms may include non-specific right upper quadrant pain or weight loss with jaundice usually indicating extensive disease in IHCC. At the time of diagnosis, only a minority (15%) of IHCC patients present with resectable disease with majority presenting with multifocality, vascular invasion, and locally advanced disease. Complete surgical resection remains the only option for cure with an estimated median survival ranging from 27 to 36 months [1]. The most common visceral metastasis is to the lungs, bones, adrenal glands, and brain, with skin being a very rare site of metastases [6]. We report an interesting case of IHCC presenting as a cutaneous lesion on the scalp.