Background: Extraskeletal osteosarcoma (ESOS) in the head as a primary site has seldom been reported and none in the frontal region.
Methods: A 78-year-old Italian man presented with one month history of a frontal soft tissue mass. A CT scan showed a mass of uneven density occupying the subcutaneous soft tissue and involving fascial planes. No primary bone tumor was found. The entire mass was excised. The mass was solid measuring 0.8 x 0.6 x 0.5 cm. Extraskeletal osteoblastic osteosarcoma was diagnosed by light microscopy. The tumor recurred four months after the diagnosis. The tumor was again ressected. The patient was also submitted to low penetration radiation therapy. Nine months after the first biopsy the patient had symptoms due to infiltration to the base of the cranium. He died 10 months after the first biopsy.
Conclusions: The first case with ESOS of the frontal region without a pre-existing condition or a history of irradiation is described.