Imaging Findings Page 1

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.

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