Virginia Commonwealth University

VCU Massey Cancer Center

Diagnosis and staging

How is hepatoblastoma diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for hepatoblastoma may include:

  • Biopsy – a sample of tissue is removed from the tumor and examined under a microscope.
  • Complete blood count (CBC) – a measurement of size, number and maturity of different blood cells in a specific volume of blood.
  • Additional blood tests – may include blood chemistries, evaluation of liver and kidney functions and genetic studies.
  • Multiple imaging studies, including:

    • Computed tomography scan (also called a CT or CAT scan) – a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general X-rays.
    • Magnetic resonance imaging (MRI) – a diagnostic procedure that uses a combination of large magnets, radio frequencies and a computer to produce detailed images of organs and structures within the body.
    • X-ray – a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs onto film.
    • Ultrasound (also called sonography) – a diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues and organs. Ultrasounds are used to view internal organs as they function and to assess blood flow through various vessels
    • Bone scans – pictures or X-rays taken of the bone after a dye has been injected that is absorbed by bone tissue. These are used to detect tumors and bone abnormalities.
    • Alpha-fetoprotein test – alpha-fetoprotein levels in the blood can be used to diagnose and follow response to treatment.

What are the different stages of childhood liver cancer?

Staging is the process of determining whether cancer has spread and, if so, how far. There are various staging symptoms that are used for hepatoblastoma. Always consult your child’s physician for information on staging. One method of staging hepatoblastoma is the following:

  • Stage I – usually a tumor that can be completely removed with surgery.
  • Stage II – usually a tumor that can mostly be removed by surgery but very small amounts of the cancer are left in the liver.
  • Stage III – usually a tumor that cannot be completely removed and the cancer cells are found in the lymph nodes.
  • Stage IV – cancer that has spread (metastasized) to other parts of the body.
  • Recurrent – the disease has returned after it has been treated. It may come back in the liver or in another part of the body.