Fig. 4

Illustrated oncologic result of case No. 9. The initial surgery was sacrectomy (S3), and 5 years later L2 metastasis was found; therefore, en-bloc spondylectomy was performed (a) and (b). Two years later T9 metastasis was detected and en-bloc spondylectomy at T9 vertebra was performed with rod extension (c, d). Three years later, wide excision of tumor with endoprosthesis replacement was performed due to proximal humerus metastasis (e, f) and total sacrectomy with extended distal fixation to ilium was performed at 3 months, subsequently (g, h)