Fibrolamellar is difficult to diagnose, primarily because its symptoms are attributed to more common causes. For example, many patients complain of general abdominal pain and fatigue. For most patients with fibrolamellar, the diagnosis is made after a CT-scan or MRI of the abdomen is performed. Imaging studies will often reveal a large liver mass. The diagnosis of fibrolamellar is then confirmed by a biopsy or after surgery to remove the mass.
The following is a video from the Mayo Clinic Laboratories which describes how fibrolamellar can be differentiated from other liver cancer types. It is a technical discussion, targetted at mainly medical professionals