Delayed Diagnosis and Self-Medication: A Devastating Consequence in Cholangiocarcinoma – A Case Report

Published on: September 2025Indian Journal of Pharmacy Practice, 2026; 19(1):132-136. Case Report| doi: 10.5530/ijopp.20260356Authors and affiliation (s): Anusreeraj R S*, Abisha Rachel M, Auxi K S, Bershlin B J, Sharmila Gigi J, Shanmathi R R Department of Pharmacy Practice, S A RAJA Pharmacy College, Tirunelveli, Tamil Nadu, INDIA. ABSTRACT Cholangiocarcinoma is a rare and aggressive malignancy originating from the bile duct epithelium. We present a case of a 33-year-old female patient diagnosed with metastatic cholangiocarcinoma, who initially presented with nonspecific symptoms such as abdominal pain, weight loss, and dyspepsia. Imaging studies revealed a large mixed solid-cystic lesion in the pelvis, multiple lung nodules, and a heterogeneous mass lesion replacing the gallbladder. Despite undergoing chemotherapy, the patient’s condition deteriorated, and she developed complications such as pulmonary thromboembolism and hepatic encephalopathy. This case highlights the aggressive nature of cholangiocarcinoma and the challenges in managing its complications. This case study highlights a classic example of delayed diagnosis, which significantly exacerbated the patient’s condition. The patient experienced symptoms for approximately one year, including abdominal pain and back pain, but neglected to seek medical attention, instead relying on self-medication and Ayurvedic remedies. This delay in diagnosis allowed the cholangiocarcinoma to progress to an advanced stage, resulting in metastasis and severe complications, including pulmonary thromboembolism and hepatic encephalopathy. The delayed diagnosis undoubtedly contributed to the poor prognosis and highlights the importance of timely medical evaluation for persistent symptoms. Keywords: Cholangiocarcinoma, Metastasis, Chemotherapy, Pulmonary thromboembolism, Hepatic encephalopathy.