Soft Tissue Sarcoma (lymph nodes)
Also covered as: neuroblastoma · Wilms tumor · metastatic disease · bilateral Wilms tumor · cutaneous melanoma · nodal involvement · pulmonary metastases
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Fundamentals
2 items
Topics in 10: Neuroblastoma
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Drs Daniel von Allmen, Todd Ponsky and Rae Hanke come together to provide you the essentials on the diagnosis and management of Neuroblastoma. Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist U
podcast10:25 · Dec 2020
Topics in 10: Wilms Tumor
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Drs Andrew Davidoff, Todd Ponsky and Rae Hanke come together to provide you the essentials on the diagnosis and management of Wilms Tumor.Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: c
podcast12:29 · Dec 2020
Surgical Management
1 item
Update Course Rewind: Highlighting Collaboration from Surgery & Interventional Radiology in the OR 2024
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In this Update Course Rewind, Drs. Dan von Allmen, John Racadio, and Timothy Lautz, alongside IR technologist Amanda Wallingford, discuss how strong collaboration between surgery and interventional radiology is transforming patient care at
video10:20 · Mar 2025
Evidence & Research
4 items
Wilms Tumor Protocol Violations: Practice Gap discussion at Update Course 2018
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At the 6th Annual Pediatric Surgery Update Course, Drs Charles Snyder, Craig Lillehei and David Powell discussthe top ten practice gaps of 2018. Here they discuss Wilms Tumor Protocol violations, focusing on ipsilateral lymph node sampling,
video9:55 · Sep 2018
BOB in Ped Surg 2023 - IPSO Winner - Steven Scoville, MD
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Watch the IPSO winner, Steven Scoville MD, present his presentation on "Comparison of outcomes between surveillance ultrasound and completion lymph node dissection in children and adolescents with sentinel lymph node positive cutaneous mela
video · Feb 2023
BOB Ped Surg 2023 - Steven Scoville, IPSO - Presentation
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Watch Steven Scoville MD, present his presentation on "Comparison of outcomes between surveillance ultrasound and completion lymph node dissection in children and adolescents with sentinel lymph node positive cutaneous melanoma."
video5:05 · Feb 2023
Indocyanine green assists with sentinel lymph node mapping in pediatric and adolescent patients
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Dr. Sophia Schermerhorn from Cincinnati Children's discusses a multicenter prospective study on the accuracy of indocyanine green (ICG) for sentinel lymph node mapping in pediatric and adolescent patients with skin and soft tissue malignanc
video1:13 · May 2026
Case-Based Learning
3 items
Lumps & Bumps: Soft Tissue Masses and Lesions
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This segment involves discussion of lumps and bumps. Dr. Danielle Walsh leads in discussion of lumps and bumps. She presents multiple case studies. Panel discussion topics include excisions, pyogenic granuloma, silver nitrate, melanoma, spi
video67:50 · Nov 2018
Neuroblastoma
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Drs Erika Newman, Dan von Allmen and Tony Sandler join Dr. Todd Ponsky in a discussion covering the latest in neuroblastoma. Contributing editor: Rachel (Rae) Hanke, MD
Case 1: Mother who presents with 26 week fetus
with a pr
podcast56:19 · Dec 2020
Update Course Rewind: Chest Wall Reconstruction 2024
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In this session from the 12th Annual Update Course in Pediatric Surgery, Dr. Margaret Mutch from Australia walks through the complexities of chest wall reconstruction following thoracic osteosarcoma resection in a pediatric patient.Key High
video5:32 · Aug 2025
In-Depth Reviews
4 items
Ovarian Tumors Video Podcast
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An interactive discussion between Dr. Ponsky and Dr. Rescorla about the management of ovarian tumors in pediatric patients. Dr. Frederick Rescorla is surgeon-in-chief at Riley Children's Hospital, Anna Olivia Healey Professor of Pediatric S
podcast34:06 · Dec 2020
Colon Cancer with Conor Delaney
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Dr. Ponsky, professor of surgery at the Cleveland Clinic Lerner College of Medicine and Department of Surgery and Dr. Colon Delaney, chairman of digestive disease and institute and professor of surgery at Cleveland Clinic Lerner College of
podcast26:50 · Dec 2020
Thyroid Disorders
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An interactive discussion about malignant and benign pediatric thyroid disorders between Todd Ponsky, MD and Diana Diesen, MD. Dr. Diesen is assistant professor of surgery and pediatric surgery fellowship program director at the University
podcast45:51 · Dec 2020
Wilms Tumor: Audio Chapter
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An interactive discussion about Wilms tumor between Todd Ponsky, MD, Avraham Schlager, and Peter Ehrlich, MD.Dr. Peter Ehrlich is a professor of pediatrics surgery at the University of Michigan C.S. Mott Children’s Hospital who is also a vi
podcast64:03 · Jan 2021
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Colon Cancer with Conor Delaney
Colonoscopy is still the best test for colon cancer detection, finding the vast majority of cancers and polyps, though not perfect
clinicalConor Delaney1:16 ↗
Serrated adenomas have good evidence of genetic predisposition and may tie into family cancer syndromes
clinicalConor Delaney2:31 ↗
Serrated polyps have a really high risk of cancer
clinicalConor Delaney2:38 ↗
Serrated adenomas are often flat and difficult to see, requiring retroflection in the cecum to visualize them on folds or around the ileocecal valve
clinicalConor Delaney3:27 ↗
For rectal resection, distal margin should be 5 centimeters if possible, 2 centimeters if achievable, and for very lowest tumors perhaps 1 centimeter as long as they are not poorly differentiated
clinicalConor Delaney6:13 ↗
Historical local recurrence rates for rectal cancer from good institutions were 20 to 38% and some up to 50%
epidemiologicalConor Delaney10:51 ↗
Current local recurrence rates for rectal cancer should be under 10%, and at Cleveland Clinic over the last 10 years it was about 3%
epidemiologicalConor Delaney11:04 ↗
Total mesorectal excision can be performed with about 5 mL of blood loss because it is a bloodless plane
clinicalConor Delaney12:24 ↗
Most accepted guidelines for neoadjuvant therapy are for tumors that are T3 (outside the wall of the rectum) or node positive
guidelineConor Delaney12:54 ↗
MRI is probably 90 to mid-90s percent accurate at T-staging and probably high 80s to 90% accurate for nodal staging
clinicalConor Delaney13:37 ↗
Endoscopic ultrasound is much more operator dependent and is probably only 70% accurate for predicting nodal involvement
clinicalConor Delaney13:56 ↗
Historical local recurrence rates for transanally excised rectal cancers was about 18%, remarkably consistent across outcome data from several big centers
epidemiologicalConor Delaney14:51 ↗
For rectal cancer, if doing transanal resection it must be full thickness excision, never an ESD-type procedure
clinicalConor Delaney16:24 ↗
In Europe, short-course radiation is 5×5 gray given over 5 days with surgery 1-2 weeks later
clinicalConor Delaney18:04 ↗
In the US, long-course radiation is 40-45 gray given with chemotherapy over 6 weeks with a 6-8 week waiting period before surgery
clinicalConor Delaney18:12 ↗
25 gray over a short period is radiotherapeutically equivalent to 40-45 gray over a longer period
clinicalConor Delaney18:26 ↗
For colon cancer, at least 12 lymph nodes should be harvested, though many surgeons hope for at least 16
clinicalConor Delaney19:51 ↗
Total mesocolic excision should be performed with 5 mL of blood loss in the plane between embryological peritoneum of retroperitoneum (Toldt's fascia) and embryological peritoneum on mesocolon
clinicalConor Delaney20:21 ↗
Scandinavian data showed local recurrence rates for colon cancer were even higher than rectal cancer rates (high 20s%) because adequate colon cancer surgery technique was not being performed
epidemiologicalConor Delaney20:48 ↗
For cecal lesions, 10 centimeters of small bowel should be taken; for mid-ascending colon, 5 centimeters should be taken
clinicalConor Delaney23:12 ↗
Extracorporeal stapled anastomosis for right colectomy has reported leak rates of 0.8% over 1000 cases
epidemiologicalConor Delaney24:00 ↗
BOB Ped Surg 2023 - Steven Scoville, IPSO - Presentation
Pediatric melanoma has approximately 500 new cases diagnosed annually in children less than or equal to 18 years old
epidemiologicalSteven Scoville0:26 ↗
Childhood melanoma is associated with delayed diagnosis and more frequently has nodal involvement compared to adults
clinicalSteven Scoville0:33 ↗
Childhood melanoma has unique disease mechanisms compared to adult melanoma
clinicalSteven Scoville0:42 ↗
Management of pediatric melanoma is based on adult studies
guidelineSteven Scoville0:44 ↗
Melanoma management is largely based on depth of the tumor and presence of metastatic disease
guidelineSteven Scoville0:49 ↗
Tumors less than 8 millimeters thick are largely managed with wide local excision
guidelineSteven Scoville0:55 ↗
Tumors greater than or equal to 8 millimeters or less than 8 millimeters with high risk features without metastatic involvement typically undergo wide local excision with sentinel lymph node biopsies
guidelineSteven Scoville1:07 ↗
Completion lymph node dissection has a high risk of morbidity
clinicalSteven Scoville1:20 ↗
Two adult trials (DCOG SLT and MSLT2) showed no significant difference in outcomes for low to intermediate risk patients with positive sentinel lymph node biopsies who were followed with ultrasound observation versus completion lymph node dissections
guidelineSteven Scoville1:29 ↗
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