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X-ray of the arms with shoulder joint anteroposterior view (a and b) showing local recurrence after previous cementing + fixation in renal cell carcinoma metastasis (c) Angiogram showing the hypervascularity. Preoperative embolisation is a must especially if intralesional surgery is contemplated (d) Resection specimen (e) Postoperative X-ray showing a nail-cement spacer. This is a cost effective construct in the upperlimb and sometimes in the lowerlimb
