{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T04:15:54Z","timestamp":1777176954846,"version":"3.51.4"},"reference-count":12,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,1,3]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>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.<\/jats:p>\n               <jats:p>The discussion touches on the rationale behind the treatment decision, the surgical approach and potential implications on the patient\u2019s functional status and quality of life post-amputation.<\/jats:p>","DOI":"10.1136\/bcr-2024-262150","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T21:20:18Z","timestamp":1737667218000},"page":"e262150","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Forequarter amputation: a viable approach for salvaging lives in chemoresistant upper limb bone tumours"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3882-8975","authenticated-orcid":false,"given":"Rajesh","family":"Ratan","sequence":"first","affiliation":[{"name":"Orthopaedics, All India Institute of Medical Science - Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prateek","family":"Behera","sequence":"additional","affiliation":[{"name":"Orthopaedics, All India Institute of Medical Science - Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4509-5434","authenticated-orcid":false,"given":"Vaishnavi","family":"Patange","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine, All India Institute of Medical Science - Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8055-9549","authenticated-orcid":false,"given":"Hem Raj","family":"Gujar","sequence":"additional","affiliation":[{"name":"Orthopaedics, All India Institute of Medical Science - Bhopal, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,23]]},"reference":[{"key":"2025082708221051000_18.1.e262150.1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.79B6.7770"},{"key":"2025082708221051000_18.1.e262150.2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4004"},{"key":"2025082708221051000_18.1.e262150.3","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1007\/s00776-009-1334-y","article-title":"Effect of increases in tumor volume after neoadjuvant chemotherapy on the outcome of stage II osteosarcoma regardless of histological response","volume":"14","author":"Kim","year":"2009","journal-title":"J Orthop Sci"},{"key":"2025082708221051000_18.1.e262150.4","doi-asserted-by":"crossref","unstructured":"Prudowsky ZD , Yustein JT . n.d. Recent Insights into Therapy Resistance in Osteosarcoma. Cancers (Basel) 13:83. doi:10.3390\/cancers13010083","DOI":"10.3390\/cancers13010083"},{"key":"2025082708221051000_18.1.e262150.5","first-page":"148","article-title":"Interscapulothoracic amputation","volume":"97","author":"Yoak","year":"2001","journal-title":"W V Med J"},{"key":"2025082708221051000_18.1.e262150.6","article-title":"Diagnosis and management of primary malignant tumors in the upper extremity","volume":"12","author":"MacKay","year":"2020","journal-title":"Orthop Rev (Pavia)"},{"key":"2025082708221051000_18.1.e262150.7","first-page":"367","article-title":"Forequarter amputation for soft tissue tumors","volume":"60","author":"Levine","year":"1994","journal-title":"Am Surg"},{"key":"2025082708221051000_18.1.e262150.8","doi-asserted-by":"crossref","DOI":"10.1186\/1477-7819-12-346","article-title":"Curative use of forequarter amputation for recurrent breast cancer over an axillary area: a case report and literature review","volume":"12","author":"Tsai","year":"2014","journal-title":"World J Surg Oncol"},{"key":"2025082708221051000_18.1.e262150.9","doi-asserted-by":"crossref","first-page":"e127","DOI":"10.1016\/j.jse.2013.09.007","article-title":"Interscapulothoracic (forequarter) amputation for malignant tumors involving the upper extremity: surgical technique and case series","volume":"23","author":"Qadir","year":"2014","journal-title":"J Shoulder Elbow Surg"},{"key":"2025082708221051000_18.1.e262150.10","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1186\/s12957-016-0973-7","article-title":"Forequarter amputation: a safe rescue procedure in a curative and palliative setting in high-grade malignoma of the shoulder girdle","volume":"14","author":"Elsner","year":"2016","journal-title":"World J Surg Oncol"},{"key":"2025082708221051000_18.1.e262150.11","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1002\/bjs.6555","article-title":"Forequarter amputation for malignancy","volume":"96","author":"Rickelt","year":"2009","journal-title":"Br J Surg"},{"key":"2025082708221051000_18.1.e262150.12","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1002\/jso.20337","article-title":"Forequarter amputation for recurrent breast cancer: a case report and review of the literature","volume":"92","author":"Goodman","year":"2005","journal-title":"J Surg Oncol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-262150","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:22:20Z","timestamp":1756308140000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-262150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,23]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2024-262150"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-262150","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}