A 53-year-old gentleman was found to have a lobulated mass over the left scapula during his annual health checkup and was referred to a musculoskeletal oncologist. The mass was provisionally diagnosed as parosteal osteosarcoma (PaOS) of the scapula, and upfront surgery was performed with wide-margin resection and reconstruction using a non-vascularised fibula graft. Histopathological evaluation confirmed low-grade parosteal osteosarcoma, with no significant nuclear atypia, hypercellularity, or mitotic figures. The postoperative recovery was uneventful, and the patient was kept on regular follow-up with physiotherapy. This case highlights that wide surgical excision with preservation of the scapula, followed by reconstruction using a non-vascularised fibular autograft, is a viable surgical strategy that can achieve satisfactory oncological clearance while preserving shoulder function. Careful preoperative planning, meticulous surgical technique, and long-term surveillance are essential to optimize functional outcomes and minimize the risk of local recurrence.

Keywords: Parosteal osteosarcoma, Fibula strut graft, Reconstruction