Since the early 1980s, limb-sparing procedures have become the standard of care for the treatment of sarcoma involving the extremities. The Tikhoff-Linberg procedure has been described as a limb-sparing option for the treatment of neoplasms of the shoulder girdle. Historically, the involvement of the chest wall with tumor has been considered an absolute contraindication for this operation. We describe a case in which a recurrent sarcoma of the shoulder girdle with chest wall involvement was successfully treated with the Tikhoff-Linberg procedure modified to include chest wall resection, along with a simple reconstructive technique.