Interdisciplinary vascular reconstructive considerations for pediatric tumors

Solid tumors with vascular involvement in pediatric patients are challenging to address. They are rare with limited data to guide treatment recommendations. Multidisciplinary management with a pediatric oncologist, pediatric surgeon, vascular surgeon and on occasion cardiac surgeon is paramount. Below, we review the scope of this problem in specific for treatment of Wilms tumor, hepatoblastoma, hepatocellular carcinoma, neuroblastoma, and sarcoma with involvement of the adjoining major vascular structures. Included in this manuscript is the role of vascular reconstruction principles as it applies to pediatric patients. We highlight the importance of individualized treatment plans taking into consideration the nature of the tumor, histology, and extent of disease; the role of neoadjuvant therapy in minimizing extent of resection; and discuss the variety of options that exist for vascular reconstruction.