Is now restricted for neglected tumors with huge soft tissue extension and neurovascular infiltration, bad response for chemotherapy with un-healing of a pathological fracture, uncontrolled infection after biopsy or over the tumor due to skin sloughing and lastly tumor recurrence after resection and reconstruction.

Advanced Osteosarcoma of
the distal femur with soft tissue extension (extracompartmental)
which means that the patient is not candidate for limb

MRI showing the massive
soft tissue extension of the tumor tissue with extension
in the popliteal fossa