This video demonstrates limb-sparing surgery involving true Tikhoff-Linberg resection for a large metastatic hepatocellular carcinoma of the shoulder girdle. In the patient shown in this video, the alternative procedure was a forequarter amputation; however, after thorough discussion with the patient and his family, a limb-salvage procedure was performed. In this type of resection, the humeral head, distal clavicle, and the scapula are resected. This is followed by soft-tissue and prosthetic reconstruction by inserting a proximal humerus prosthesis, securing the prosthesis to the rib cage, and providing coverage via a rotational muscle flap. At 2 months postoperatively, the patient was doing well, with no reports of considerable pain and a well-healing incision. The prosthesis was still adequately secured to the third rib, and the patient was cleared to return home for systemic treatment.