If your child's doctor suspects liver cancer, your child's history will be checked for risk factors. Your child's belly is also closely looked at during exams. Masses or lumps in the liver and belly often can be felt while your child is lying flat on the exam table. The liver most often is swollen and hard in patients with liver cancer.
The doctor will use a stethoscope to listen to the blood vessels that lie near the liver. They may be able to hear a sound that is not normal or a rubbing noise. The pressure of the tumor on the blood vessels causes the noises.
Your child's doctor may use other methods to diagnose HCC. They include:
Blood tests. Between 50 percent to 70 percent of liver tumor patients have high levels of serum alpha-fetoprotein. Blood tests can tell if high levels are present in your child's blood. This test cannot be used by itself to diagnose HCC, as other diseases can also cause high levels. More blood work (such as hepatitis B, iron, total iron binding capacity, ferritin and alpha-1 antitrypsin) may help find any risk factors.
Imaging studies. Imaging studies help find tissue in the liver that is not normal. Liver tissue as small as an inch across now can be found by ultrasound, computed tomography scan (CT scan), or magnetic resonance imaging (MRI). But, these imaging studies cannot reliably tell the difference between a hepatocellular carcinoma and other abnormal masses or lumps of tissue.
Biopsy. A biopsy (when a sample of tissue is removed and checked) of the tumor may be done to provide a clear diagnosis of HCC. Either a sample of the liver or tissue fluid will be removed or the tumor will be fully resected (removed). A microscope will be used to see if there are cancer cells present.
Once HCC is found, more tests are done to find out if cancer cells have spread to other parts of the body. This is called staging. Your child's doctor needs to know the stage of the disease to provide the right treatment.
These stages are used to define HCC:
- Stage I: The cancer can be removed with surgery.
- Stage II: Most of the cancer may be removed in surgery, but microscopic (cannot be seen) amounts of cancer may remain in the liver after surgery.
- Stage III: Some of the cancer may be removed in surgery, but some of the tumor cannot be removed. Macroscopic (visible by the surgeon or by imaging) amounts remain either in the liver or in the lymph nodes (part of the body that filters out and gets rid of cancer cells and other waste products from the body).
- Stage IV: The cancer has spread to other parts of the body.