. A Cholangiocarcinoma is classified by location as intrahepatic and hilar/extrahepatic. Intrahepatic cholangiocarcinoma is typically asymptomatic until the tumor is advanced, at which time right upper quadrant discomfort, weight loss, and fever may be the only symptoms. An elevated serum alkaline phosphatase level may be noted. Risk factors for cholangiocarcinoma are primary sclerosing cholangitis, biliary atresia, chronic infection with liver flukes, and biliary cysts.