Bone tumors are infrequent within the scapula. Total scapulectomy with massive allograft reconstruction\nrepresents an attractive alternative to amputation when the whole scapula is invaded\nwith tumor and the neurovascular bundle can be preserved during tumor resection. We report a\ncase of resection of the scapula and proximal humerus for recurrent osteosarcoma with massive\nallograft reconstruction of the scapula and proximal humerus. A 22-year-old male patient was\nseen in February 1992 for a pathological fracture of the proximal left humerus. In July 1992, a resection\nof the proximal end of the humerus followed by a reconstruction with osteochondral allograft\nand nail osteosynthesis was performed. The postoperative course was uneventful. In September\n2009, 17 years later, the patient presented with a huge tumor developed at the level of the\nscapula. There was no vascular or neurological symptom. Plain radiography showed an expansive\nosteolytic mass. CT scan demonstrated scapular and proximal humerus invasion. An extended assessment\nrevealed the presence of two pulmonary nodules. The biopsy confirmed the recurrence\nof osteosarcoma. The indication of a resection of both the left scapula and the 1992 allograft which\nwas completely invaded at its proximal portion and the complete reconstruction of the scapula\nand the proximal humerus with allograft was made. One year postoperatively, we note a favourable\noutcome in terms of musculoskeletal functions. Despite two resection surgeries of pulmonary nodules and chemotherapy treatments, the patient developed new lung metastases and an unfavourable\noutcome. Although shoulder function was almost completely eliminated following surgery,\npreservation of elbow, wrist and finger motion resulted in an acceptable level of postoperative\nlimb function. This reconstruction appears to be an attractive technique to be used in similar\ncases. The necessity of a reliable tissue bank with quality allografts in sufficient number is paramount.
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