The doctor will take a complete medical history and give the child a physical examination.
A complete blood count and other blood tests that indicate how the liver is functioning will be performed.
The doctor may perform a blood test for alpha-fetoprotein (AFP). High levels of AFP may signal early-stage liver tumors in children who have a high risk of developing the disease. Elevated AFP levels are most often found in hepatocellular patients. In addition to diagnosing the disease, AFP is also used to monitor the child's response to treatment.
The doctor may use a computed tomography (CT) scan to create a picture of the cancer and to determine if it has spread. In CT imaging, a scanner moves around the body taking hundreds of X-ray images, which a computer then combines to make a three-dimensional image of the inside of the body. Sometimes a special dye is injected to help provide better detail. Other options are ultrasonography, which uses sound waves to create images of organs, or a magnetic resonance imaging (MRI) scan, which uses electromagnetic waves to create images.
The child may also need to undergo a liver scan. In this procedure the doctor injects a gamma ray-emitting material into a vein. After the liver has time to absorb this material, the child is placed under a scanner, which detects the gamma rays and creates a three-dimensional image of the liver. Cancerous tissue looks whiter than normal tissue on this image.
The doctor will perform a biopsy of liver tissue. This is a definitive test, meaning that most of the time, the disease is diagnosed using this procedure. The doctor may perform surgery to look at the liver and remove a piece of tisse or use a fine needle biopsy (inserting a thin needle to remove tissue) guided by ultrasound or a CT-scan. Tissue samples are then examined under a microscope for cancer cells.
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