The novelty of the Tikhoff-Linberg resection with endoprosthetic replacement makes it important to establish Pre-op and Post-op imaging criteria.
Pre-operative Imaging Findings
- Proximal humeral or scapular tumor on conventional radiographs. Note the proximal humeral (below left) and scapular chondrosarcomas (below right).
No axillary neurovascular involvement on CT or MR.
Chest CT, axial: Note the scapular chondrosarcoma (black arrow) with no axillary neurovascular bundle encasement (white arrow).
Shoulder CT, axial: Note the scapular chrondrosarcoma (white arrow) with axillary neurovascular clear of tumor (black arrow).
Shoulder T1 MRI, axial: Note that the neurovascular bundle (black arrow) is not involved by the scapular Ewing sarcoma (white arrow).
Shoulder MRI, axial: Note the lack of neurovascular (black arrows) involvement of this patient's chondrosarcoma (white arrows) on T1, left, and STIR, right.
Shoulder T1 MRI, sagittal: Note, again, the axillary neurovascular bundle (arrowhead) is not encased by tumor (arrow).
- Tumor response to chemotherapy make patients better surgical candidates.
Shoulder MRI, axial: Note the large pre-chemotherapy shoulder mass, above left, and shrunken tumor with necrotic center (outlined in pink) after chemotherapy, above right.