Rebuilding Alma's Shoulder—and Her Future

When 12-year-old Alma first complained of shoulder pain, nobody in her family was alarmed. Her parents figured it was a sports injury—maybe muscle strain from the cold. Even the orthopedic specialists found nothing unusual and recommended physical therapy.

But the pain got worse. Then came the swelling that would not go away.

Alma’s parents grew more concerned. They brought Alma to a local hospital where Alma got an MRI. Her parents then sent the images to Schneider Children's Medical Center of Israel, Israel’s sole stand-alone pediatric hospital. Dr. Israel Weiss, Director of the hospital’s Orthopedic Oncology Unit, was abroad at the time. He reviewed the scan remotely and phoned Alma’s parents, instructing them to bring Alma in immediately for a biopsy. 

The diagnosis was Ewing sarcoma—a rare and aggressive bone cancer. In Alma's case, the tumor had grown in an exceptionally uncommon location: the shoulder blade.

"This is a type of bone cancer, the second most common among children. It is a very rare and aggressive tumor that accounts for about 3% of pediatric cancers, primarily affecting children between the ages of 10 and 15,” said Dr. Shiri Rubin, Alma’s attending physician and a senior oncologist in the Hemato-Oncology Division at Schneider Children's. 

“Due to its rarity, we typically encounter only one or two cases yearly,” adds Rubin. 

Alma's doctors moved fast.

First, Alma underwent ovarian tissue preservation surgery—standard protocol for young patients facing the kind of chemotherapy that can affect future fertility. Months of intensive treatment followed to shrink the tumor and prepare Alma’s body for surgery.

From the start, Alma’s surgical team faced a complex challenge. Removing the entire shoulder blade was necessary to eliminate the cancer. But doing so would compromise Alma's arm function and alter her appearance at an age when both matter deeply. The question became how to treat the disease without limiting Alma’s life going forward.

In planning the operation, Dr. Weiss and his team utilized Schneider Children's hi-tech, in-house 3D development center. The doctors scanned Alma's healthy shoulder blade and created a mirrored digital model. Doctors then fabricated a custom prosthesis designed to match the exact size, shape and weight of the bone they would remove.

The six-hour surgery required precise coordination across multiple specialties—oncology, orthopedics, anesthesiology and rehabilitation. The cancerous shoulder blade was removed and replaced with the 3D-printed implant. 

Alma is now in physical therapy, rebuilding strength and range of motion in her arm. She's completing her final rounds of chemotherapy, and her doctors remain cautiously optimistic.

At Schneider Children's, treating the whole child means more than eliminating disease. It means ensuring the child thrives.