210 IMAGING FINDINGS IN LIMB-SPARING SURGERY AND ENDOPROSTHETIC PLACEMENT FOR SHOULDER GIRDLE NEOPLASIA

Dramatic change has been seen in the treatment of shoulder girdle neoplasia. Forequarter amputation was once the treatment of choice for aggressive tumors in this area. Today, the great majority of shoulder girdle malignancies are treated with limb-sparing procedures like the Tikhoff-Linberg resection, which involves removal of the scapula, humeral head, outer third of the clavicle, and surrounding soft tissues. With advancements in surgical and endoprosthetic technology, expectations of surgeons and patients have increased and limb preservation without reasonable function is no longer acceptable. Since en bloc total scapular and proximal humeral resection can leave a flail upper extremity, the goal of modern skeletal reconstructions is to maintain near normal hand and elbow function by stabilizing the shoulder. The most recent techniques also attempt to restore some shoulder function. Published reports documenting these notoriously difficult procedures and their post-operative imaging findings are scarce. This is an educational exhibit designed as a Web site containing didactic text and numerous operative photographs, plain film, CT, and MR images, as well as patient videos. Viewers will navigate the site using a toolbar located on each page that contains links to pages including prevalence of shoulder neoplasia, relevant shoulder anatomy, mechanisms of tumor spread, historical therapeutic perspectives, surgical options, surgical indications, operative techniques, methods of reconstruction, implant types, pre- and post-operative imaging findings, and patient functionality based on the series from our institution.