Sarcoma is a type of cancer that develops in bones and soft tissues, such as fat, muscles blood vessels, etc. Tissue becomes necrotic when substantial areas of tissue lack a blood supply, which then causes gangrene, or death of the tissue, in the area. This particular case was very vascular, so there was no way to approach it in a controlled fashion. We had to go full speed ahead and we removed it in less than 20 minutes then achieved hemostasis. A common question is how do cases get to this degree of severity in remote locations. Many different factors, such as lack of equipment, lack of knowledge, and doctors thinking the case is a lost caused all contribute to delayed treatment. This young girl is doing great and is going home in 5 days.