University of California San Francisco | About UCSF | UCSF Benioff Children's Hospital San Francisco
Search Site | Find a Doctor

Liver Cancer
Diagnosis

In making a diagnosis of liver cancer, your doctor will evaluate your medical history and perform a careful physical examination. Certain tests also will be recommended.

For people at increased risk of developing primary liver cancer, such as those with chronic viral hepatitis or cirrhosis, the current recommendation is to have an alpha-fetoprotein blood test and an ultrasound examination of the liver, at least annually. While not perfect, these tests increase the chances of detecting liver cancer at an early stage.

Certain blood tests are used to see how well the liver is functioning.

X-rays of the chest and abdomen, angiograms or X-rays of blood vessels; CT scans, or X-rays put together by computer; and magnetic resonance images (MRIs), created by using a magnetic field, may be part of the diagnostic process.

If there is uncertainty about the diagnosis, the presence of liver cancer may be confirmed with a biopsy. Tissue from the liver is removed through a needle or during an operation and checked under a microscope for the presence of cancer cells. Your doctor also may look at the liver with an instrument called a laparoscope, which is a small tube-shaped instrument with a light on one end. For this procedure, a small cut is made in the abdomen so that the laparoscope can be inserted. Your doctor may take a small piece of tissue during the laparoscopy. A pathologist then examines the tissue under the microscope to see if cancer cells are present.

Once primary liver cancer is found, more tests will be performed to determine if cancer cells have spread to other parts of the body.

Staging

The following stages are used for adult primary liver cancer:

  • Localized resectable — Cancer is found in one place in the liver and can be completely removed by surgery.
  • Localized unresectable — Cancer is found only in one part of the liver, but the cancer cannot be totally removed.
  • Advanced — Cancer has spread through much of the liver or to other parts of the body.
  • Recurrent — Cancer has come back or recurred after it was treated. It may come back in the liver or in another part of the body.

Reviewed by health care specialists at UCSF Medical Center.