BackgroundExtraskeletal osteosarcoma (ESOS) is a highly malignant osteosarcoma that occurs in extraskeletal tissues. It often affects the soft tissues of the limbs. ESOS is classified as primary or secondary ESOS. Case presentationwe report a case of primary hepatic osteosarcoma in a 76-year-old male patient. The patient had a giant cystic-solid mass in the right liver that was evident on ultrasound and computed tomography. Postoperative pathology and immunohistochemistry of the mass, which was surgically removed, suggested fibroblastic osteosarcoma. No other abnormal lesions were found. Therefore, the patient was diagnosed with primary hepatic osteosarcoma. The hepatic osteosarcoma reoccurred 48 days after surgery, resulting in significant compression and narrowing of the hepatic segment of the inferior vena cava. Consequently, the patient underwent stent implantation in the inferior vena cava and transcatheter arterial chemoembolization. Unfortunately, the patient died of postoperative multiple organ failure.ConclusionsHepatic osteosarcoma is a rare mesenchymal tumor with a short course and a high likelihood of metastasis and recurrence. If a biopsy were to return osteoid in a large liver tumor, ESOS would be suspected. However, there is no evidence-based treatment plan to date. Surgical resection combined with adjuvant chemoradiotherapy seems to be the best treatment option.
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