Diagnosis
There are several tests and procedures that the doctor may perform in order to properly diagnose hepatoblastoma. The most common of these include:
Physical Exam
The doctor may take a detailed medical history to determine any risk factors your child may have. During a physical exam, the doctor can check for certain symptoms of hepatoblastoma such as jaundice, swelling or pain in the abdomen, or physical changes to internal organs like the liver and spleen.
Blood Tests
The doctor may want to measure the amount of alphafetoprotein (AFP) in your child's blood by performing an AFP blood test. A high AFP count may be an early indication of hepatoblastoma. This test can also help the doctor monitor your child's response to treatment. The doctor may also want to perform a complete blood count (CBC), a procedure in which a sample of blood is checked for the number of red blood cells, white blood cells, and platelets. Additionally, the doctor may recommend blood chemistry tests to evaluate and monitor your child's liver and kidney function.
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Computed Tomography (CT) Scan
A computed tomography (CT) scan uses X-rays to produce an image of the body. A special dye may be injected into the patient's veins and he or she may be asked to drink a special fluid in order to make the internal organs stand out. A CT scan reveals the presence of tumors and whether or not the cancer has spread to other parts of the body.
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Magnetic Resonance Imaging (MRI)
An MRI uses magnetic fields, which are not harmful, to create clear and detailed images of organs and structures in the body. The tissues absorb the energy from these fields in patterns and then release them, depending on the type of tissue and disease. These patterns are then translated by a computer to provide images of multiple “slices” of the body.
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Endoscopic Ultrasound (EUS)
An endoscope is a thin tube with a camera and a light on the end. In this procedure, the doctor inserts an endoscope with an ultrasound transducer attached at the end. The transducer bounces sound waves off of internal organs in order to create a picture of the pancreas, as well as nearby organs and lymph nodes.
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Ultrasound
An ultrasound is a quick, easy, and painless method to test for liver cancer. During this procedure, a transducer is positioned directly on the skin of the abdomen. The transducer then bounces sound waves off of internal organs in order to create echoes that form a picture. Not only can an ultrasound indicate the presence of a tumor, it can also show the tumor's shape, size, and number of tumors.
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Laparoscopy
A laparoscopy is a small operation used to visually examine the liver. The procedure involves creating a small incision in the abdomen and using a laparoscope (a thin tube containing a camera and a light) to look for any abnormalities. A sample (biopsy) of the liver may also be removed during the procedure.
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Biopsy
A biopsy consists of removing a sample of tissue and then looking at it under a microscope to determine if the tissue is cancerous. The tissue sample may be obtained by inserting either a thin needle using an ultrasound, a CT scan or a laparoscope to guide the needle into the tumor. A liver biopsy provides the most accurate diagnosis of liver cancer.
