Your child will have a number of tests to investigate their symptoms and confirm a diagnosis of a liver tumour, including:
- medical history and physical examination
- blood tests
- urine tests
- medical imaging, which may include
- computed tomography (CT) scan
- magnetic resonance imaging (MRI)
- biopsy – where a small sample of the tumour is removed to be examined under a microscope. The sample can also be tested for genetic changes that can help determine the best type of treatment for your child.
These tests are explained in more detail in How is cancer diagnosed?.
If your child is diagnosed with a liver tumour, some of the diagnostic tests will also help to stage the tumour. Staging determines where the tumour is, how big it is and whether it has spread to other parts of the body. This is important to determine the outlook (prognosis) for your child, and to decide on the best options for treatment.
There are different ways to assess the stage or extent of disease. Two of the most common ways to stage liver cancer are used either before or after surgery.
Staging before surgery is known as the PRETEXT method. This method uses medical imaging scans to see how far the cancer has spread within the liver. The liver is imagined as being divided into 4 sections:
- Stage 1 – the cancer is in 1 section of the liver, and 3 sections that are next to each other do not have cancer.
- Stage 2 – the cancer is in 1 or 2 sections of the liver, and 2 sections that are next to each other do not have cancer.
- Stage 3 – the cancer is in 3 out of 4 sections of the liver; or it is in 2 sections of the liver, and 2 sections that are not next to each other do not have cancer.
- Stage 4 – the cancer is in all 4 sections of the liver.
Staging after surgery uses the following method:
- Stage I – the cancer had not spread outside the liver and was completely removed by surgery.
- Stage II – the cancer had not spread outside the liver, but some cancer cells remain after surgery that can be seen under a microscope.
- Stage III – the cancer cannot be removed by surgery, or visible cancer remains after surgery, or the cancer has spread from the liver to nearby lymph nodes.
- Stage IV – the cancer has spread to other parts of the body, such as the lungs or brain.