Table 2: Resection and Reconstruction of Bone and Muscles and Clinical Results Patient Muscles resected Muscles reconstructed Site of bony lesion Size of lesion (cm3) Oncological results SS, IS, SSC, BB, SA SS, IS, BB SS, IS, SSC, RR, LS, T SS, IS, T, R T, TMI, TMA, SSC, T, LD, SSC LD SS, IS, SSC, BB, CB, D, CB, BB TMI, TMA, D SS, IS, SSC SS, IS, SSC SS, IS, SSC, TB, TMI, None TMA SS, IS, SSC, T, D, TMI, T, LD TMA, LD, SA S, SF, AP, G, CP, SN S, SF, AP, C, CP SN, AP, S, G SN, G, SF S, SF S, SF, IF, TBS SF, G, SN, CP 25 × 5 × 6 10 × 8 × 7 16 × 11 × 4 12 × 11 × 10 7 × 4 × 4 5 × 4 × 3 20 × 15 × 5 A A AWD A DOD A A Complications None Deep infection None Pain None Dead None Journal of Experimental & Clinical Cancer Research 2009, 28:45 http://www.jeccr.com/content/28/1/45 SS: supraspinatus, IS: infraspinatus, TMI: teres minor, TMA: teres major, SSC: subscapularis, SA: serratusanterior, D: deltoid, BB: biceps brachii, TB: triceps brachii, T: trapezius, LD: Latissimus dorsi, R: rhomboideus, LS: levator scapula, CB: coracobrachialis, R: rhomboideus, SF: supraspinous fossa, IF: infraspinous fossa, S: spine, CP: coracoid process, AP: acromion process, SN: scapular neck, G: glenoid, C: clavicle, TBS: the border of the scapula, DOD: dead of disease, AWD: alive with disease, A: alive without evidence of disease. 1 2 3 4 5 6 7 1 2 3 4 5 6 7 5 5 5 3 5 5 5 3 4 3 3 4 2 3 3 5 5 4 5 3 4 3 5 4 5 5 3 4 5 5 5 5 5 5 4 3 4 4 3 3 3 3 22(73%) 28(93%) 26(86%) 23(76%) 27(90%) 21(70%) 23(76%) 50°-30° 110°-80° 80°–90° 35°–45° 80°-55° 40°-35° 60°-40° Page 3 of 10 (page number not for citation purposes) mary lesion of the scapula for all seven patients were mainly detected in region S2, the acromion/glenoid com- plex (Figure 1, Figure 2) with partial lesions occurring in region S1, the blade/spine of the scapula as categorized using the MSTS classification [1]. The incision was cen- tered in the middle of the tumor. Thus, a posterior exten- sile incision was made in four patients (#1, 2, 5, and 6) starting at the inferior angle along the medial border of the scapula, curving laterally through the spine to the tip of the acromion. The overall length of the incision was determined based on the extent of each patient's lesion. In another patient (#7), a vertical incision was created that extended along the lateral border from the inferior angle of the scapula to the intermedial portion of the clavicle, following the previous incision made during a prior par- tial scapulectomy. In another patient, (#3) the incision had the same starting point as the patient #7, but then extended medially from the lateral superior angle to the medial superior angle of the scapula along the spine. In the last patient, (#4) the incision was extended from the sternoclavicular joint along the clavicle and continued over the shoulder along the deltopectoral groove. Table 3: Functional Results According to ISOLS Criteria Resection and surgical margins The affected supraspinatus, infraspinatus, and subscapu- laris were identified in six patients (#1, 2, 4, 5, 6, and 7). The involved teres minor and teres major in four patients (#3, 4, 6, and 7) and the affected trapezius in three patients (#2, 3, and 7) were identified. The involved par- tial deltoid (anterior or posterior), latissimus dorsi, and biceps brachii were identified in two patients, respectively (#4 and 7, #3 and 7, and #1 and 4). The affected serratus anterior, coracobrachialis, rhomboideus, and the supras- capularis were identified in one patient each (#1, 4, 2, and 1, respectively). The articular capsule was essentially intact in all patients. After exposing each patient's tumor, the supporting musculature was examined. The rotator cuff was involved most frequently (particularly the suprasp- inatus) and the deltoid was involved at a somewhat lower frequency. A partial scapulectomy (Type IIA) was performed in all patients as previously described [14]. The resection of all involved soft tissues was extralesional, with a 2 to 5 cm margin. Thus, according to the extent of the lesion in these patients, little of the deltoid, latissimus dorsi, or biceps brachii were resected due to partial tumor invasion. The Case Pain Function Emotional acceptance Hand positioning Manual dexterity Lifting ability Total score Abduction and flexion