Topic: Polyneuropathy preceding diagnosis
Hello to everyone.
I just recently came upon this board with loads of helpful information about this devastating illness. Thank you for being there.
I wonder if there is anyone out there with cholangiocarcinoma who experienced signs of neuropathy PRIOR to the diagnosis of the disease. (Chemotherapy can have this as a side-effect, but this is not what I mean).
Briefly my history:
I had a normal physical and normal labs at the end of December of 2011. We celebrated my 70th birthday in May of 2012 (70 going on 50, both in energy and appearance, never having had a serious illness before, non-smoker, non-drinker, physically active).
At the end of June 2012 I developed some intermittend numbness in my toes and fingertips. I first did not pay much attention to this, but as the tingling and numbness worsend over time, I went to my GP for some blood tests and a neurological referral. The neurologist confirmed a mild polyneuropathy and explained that nearly half of the cases have no good explanation. The blood tests showed mildly elevated liver enzymes, which lead to a sonogram, which lead to an MRI of the liver.The first impression of the radiologist was that of
a giant hemangioma and the GI specialist refused a biopsy since I did not have any cancer-related symptoms and negative markers. However, more refined imaging studies ruled out the hemangioma impression. So the biopsy was finally performed in the first part of September.
Diagnosis: Poorly differentiated cholangiocarcinoma.
Because of its size and proximity to large blood vessels it was difficult to find a center that still agreed to operate. I finally underwent, at the end of September, an extended right hemipepathectomy, leaving me with a calculated 28% of the liver. The postoperative course involved a prolonged stay in ICU because of massive blood loss and respiratory difficulty. The tumor was removed with what appeared to be clear margins and the lymph nodes were negative. So, there was some hope.
We did not start any adjuvant therapy, its usefulness being doubtful in this disease.
On returning home, I was still weak but did not have significant neurological
symptoms. Unfortunately the polyneuropathy has now returned full force and even though, MRI, bone and PET scan have so far been negative, I am afraid
that this can be a sign of tumor recurrence which may show up soon.
Over the last weeks I have searched the internet for similar cases, but in vain.
Theoretically, the appearance of neurological symptoms in cholangiocarcinoma can occur (it is known as "paraneoplastic syndrome" and shows up most often in patients with small cell carcinoma of the lung),yet I fail to find any real-life documentation for this in bile duct cancer anywhere.
If you have experienced something like this or know someone who has, please let me know. I would greatly appreciate it.
Thank you ever so much.