Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
Video
Error Traps and Culture of Safety in Pediatric Surgical Oncology
CCHMC Pediatric Surgery · Published Sep 2019
Video
Social Determinants of Health Influence on Survival in Wilms Tumor, Neuroblastoma, and Hepatoblastoma
1 min · Published Jan 2026
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Update Course 2023 - Updates in the use of ICG
19 min · Published Aug 2023
Podcast
Hepatoblastoma
54 min · Published Nov 2017
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Hepatoblastoma: Update Course 2014
24 min · Published Nov 2018
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Quality of Life Outcomes for Patients Who Underwent Conventional Resection and Liver Transplantation for Locally Advanced Hepatoblastoma
1 min · Published Jan 2026
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Clinical & Research Update: Renal Tumors with Drs. Ethan Smith, Lindsay Haacker, Michael Daugherty, and Meera Kotagal
71 min · Published Sep 2026
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Clinical & Research Update: Neuroblastoma with Drs. Katherine Somers, Cara Morin, Juan Gurria, and Meera Kotagal
67 min · Published Sep 2026
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Clinical & Research Update: Sarcoma w/ Drs. Roshni Dasgupta, Joseph Pressey, Arthur Meyer, Luke Pater
66 min · Published Sep 2026
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Update Course Rewind 2025: Nerve Monitoring in Pediatric Thyroid Surgery
6 min · Published Jul 2026
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Journal of Pediatric Surgery Article Review: June 2023, AAP Issue
Todd Ponsky · 13 min · Published Jul 2026
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Pediatric Surgical Oncology Research Collaborative (PSORC): Studying Rare Pediatric Tumors
56 s · Published May 2026
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Update Course Rewind: MMP-7 & Biliary Atresia Diagnosis 2024
CCHMC Pediatric Surgery · 6 min · Published Mar 2025
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Biliary Atresia with Dr. Greg Tiao
CCHMC Pediatric Surgery · 11 min · Published Jun 2022
Podcast
Biliary Atresia Part II
42 min · Published Feb 2022
Podcast
Biliary Atresia Part I
31 min · Published Jan 2022
Video
Biliary Atresia
CCHMC Pediatric Surgery · 20 min · Published Nov 2018
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Compiled Sandler Rapid Fire Sessions: Update Course 2015
29 min · Published Nov 2015
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GYN #4 Management of Tubal Torsion: When to Consider Salpingectomy with Dr. Lesley Breech
CCHMC Pediatric Surgery · Published Oct 2024
Podcast
Pyloric Stenosis with Dr. Alex Bondoc
16 min · Published Jun 2024
Video
GYN #3 Management of an Adnexal Torsion with a Healthy Appearing Ovary with Dr. Lesley Breech
CCHMC Pediatric Surgery · Published May 2024
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GYN #2 Oophoropexy in Adnexal Torsion with Dr. Lesley Breech
CCHMC Pediatric Surgery · Published May 2024
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GYN #1 Importance of Documenting Reproductive Anatomy with Dr. Lesley Breech
CCHMC Pediatric Surgery · Published Feb 2024
Podcast
Esophageal Replacement with Dr. Dan von Allmen
13 min · Published Nov 2023
What the experts said
Hepatoblastoma is the most common malignant liver tumor in the pediatric population
Treatment strategies for hepatoblastoma have changed dramatically over the past 25 years
There are around 250 new cases of hepatoblastoma per year
Hepatoblastoma is nowhere near the most common liver tumor or the most common abdominal tumor in children
Neuroblastoma is the most common solid malignancy in the pediatric population
Hemangioma is the most common liver lesion in children
Hepatoblastoma can present as an asymptomatic abdominal mass, tumor rupture, or respiratory distress due to tumor size
Hepatoblastoma can present as a paraneoplastic syndrome like precocious puberty
An elevated alpha fetoprotein (AFP) is a key component in the workup and is critical for the diagnostic algorithm and treatment response
Most experts rely on MRI to delineate anatomy and evaluate the extent of liver involvement in hepatoblastoma
Eovist is an MRI contrast agent taken up by hepatocytes and then excreted, providing the best definition when looking at the liver on imaging
To establish a diagnosis of hepatoblastoma, four things are needed: history, abdominal imaging, AFP check, and liver biopsy
The most important intervention for survival is to achieve complete resection
Aggressive resections include trisectionectomy, mesohepatectomy, resection with additional procedure in remnant liver, and liver transplantation
Couinaud labeled liver segments in a counterclockwise fashion by injecting portal vessels, similar to how districts of Paris are labeled
The right hepatic vein differentiates anterior and posterior sections of the right liver
The right portal vein separates superior and inferior segments of the right liver
The pre-text staging system classifies tumors based on the number of contiguous liver sections free of disease (minus four equals pre-text stage)
Pre-text 1 has three contiguous sections free of disease, pre-text 2 has two, pre-text 3 has one, and pre-text 4 has no free sections or diffuse tumor
Pre-text 1 and 2 tumors with greater than 1 cm margin from middle hepatic vein and portal bifurcation should be considered for resection at diagnosis
Pre-text 3 and 4 tumors represent a big game changer in practice that improved survival from less than 30% in the 1970s-80s to 80-90% today
Pre-text 3 tumors should generally be biopsied at diagnosis, started on neoadjuvant chemotherapy, then referred to transplant center or center with expertise in advanced liver resections
Indications for transplant in pre-text 3 or 4 disease include unresectable disease, unsafe resection, or inadequate liver remnant
It is important to consult a transplant center early for pre-text 3 and 4 tumors
The PHITT (Pediatric Hepatic International Tumor Trial) is an ongoing multinational trial to identify high and low risk features for each pre-text stage
The PHITT study has been ongoing for three years