Forequarter amputation: a viable approach for salvaging lives in chemoresistant upper limb bone tumours

This case revolves around a mid-childhood boy diagnosed with a chemoresistant chondroblastic osteosarcoma, a rare and aggressive form of bone tumour affecting his left proximal humerus. Histopathological confirmation of chondroblastic osteosarcoma was obtained through core-needle biopsy. Despite initiating cytoreductive neoadjuvant chemotherapy using a vincristine and cyclophosphamide regimen, the tumour exhibited resistance, prompting the decision to proceed with a forequarter amputation. The patient underwent a planned forequarter amputation by an anterior approach that involved careful dissection of soft tissues, especially around vascular and neural structures. The procedure aimed at achieving complete resection of the chemoresistant tumour. Notably, the case underscores the challenges posed by chemoresistance and the need for radical interventions in such complex clinical scenarios.The discussion touches on the rationale behind the treatment decision, the surgical approach and potential implications on the patient's functional status and quality of life post-amputation.