Most liver cancers are found because of symptoms; however, testing those at high risk for the disease may diagnose individuals earlier. The disease can be diagnosed via medical history and physical exam, imaging tests, ultrasound, CT scan, MRI, angiography, bone scan, biopsy and lab tests.

Liver cancer is usually diagnosed using the TNM system: size of the tumor, spread to nearby lymph nodes and metastasis:

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  • Stage 1A: a single tumor that is 2 centimeters or smaller that hasn’t grown into blood vessels and has not spread to nearby lymph nodes or to distant sites.
  • Stage 1B: a single tumor larger than 2 centimeters that hasn't grown into blood vessels and has not spread to nearby lymph nodes or to distant sites.
  • Stage 2: either a single tumor larger than 2 centimeters that has grown into blood vessels or more than one tumor but none larger than 5 centimeters across, but has not spread to nearby lymph nodes or to distant sites.
  • Stage 3A: more than one tumor, with at least one tumor larger than 5 centimeters across, but has not spread to nearby lymph nodes or to distant sites.
  • Stage 3B: at least one tumor of any size that has grown into a major branch of a large vein of the liver, but has not spread to nearby lymph nodes or to distant sites.
  • Stage 4A: any size single tumor or multiple tumors that spread to nearby lymph nodes, but not to distant sites.
  • Stage 4B: a single tumor or multiple tumors of any size that may or may not have spread to the lymph nodes, but has metastasized.