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Radical Resection of the Left Scapula in Patients With Dedifferentiated Chondrosarcoma

March 01, 2019

Contributors: Tyler Hoskins; Laura Sonnylal, BS; James C Wittig, MD, FAAOS; Rohan Sampat; Rohan Sampat

Dedifferentiated chondrosarcoma is a rare, highly aggressive and malignant cartilage-forming neoplasm. Dedifferentiated chondrosarcomas account for approximately 10% of all chondrosarcomas. A dedifferentiated chondrosarcoma is characterized by two distinct histologic components: a low-grade, malignant hyaline cartilage tumor and a high-grade, nonchondroid spindle sarcoma, which are juxtaposed by a clear demarcation line. Given the high-risk of metastasis and the lack of evidence to support a positive response to chemotherapy in patients with dedifferentiated chondrosarcoma, the most recommended curative treatment approach is complete surgical resection of the tumor. This video discusses the case presentation of a patient with a dedifferentiated chondrosarcoma in the left scapula and details resection of the left scapula and a Tikhoff-Linberg suspension of the humerus from the clavicle to maintain arm function. The video demonstrates many aspects of the procedure, including the posterior incision, radical resection of the left scapula, mobilization of the brachial plexus, the creation of a latissimus dorsi muscle flap, biceps tenodesis, and dynamic suspension of the humerus from the clavicle.