Primary Osteogenic Sarcoma of the Skull

Osteogenic s arcoma, which most commonly affects the long bones, has been encountered only very rarely as a primary t umor of the skull. Ingraham a nd M atson 2 state that, in children, primary m alignant sarcomas may occasionally occur at this site; they point out that histologically the tumor m ay be osteogenic or more commonly fibrosarcoma, and they report a case of the latter. Davidoff et al. ~ presented a case of osteogenic sarcoma in a woman who received radiation therapy for a tumor diagnosed as osteoma at another institution 6 months previously. In the discussion of the same paper, H. G. Jacobson recalled ~ other examples. In Rowbotham's series 5 of ~0 cases of tumor involving the skull, there was not a single case of osteogenie sarcoma and the author even expressed doubt as to whether a primary growth of this kind ever occurred. It seems to develop in association with Paget's disease, 6 as a late complication of radiotherapy 4 or in relation to other tumors of the cranium2 A case of primary osteogenic sarcoma is reported here. Case Report A ~0-year-old youth was admitted complaining of weakness of the right leg and blurring of vision. About a year previously he had begun to suffer from frontal headaches, buzzing in the ears, visual disturbances and periods of weakness of the right leg. Impaired appetite had been followed by a loss in weight of some 5 kg. Examination. The patient was cooperative but not able to answer questions clearly. A firm regular mass about 6 cm. in diameter and sensitive to pressure, projected from the left parietal region, extending over the midline. There was weakness of the right limbs, especially of the leg, with some spasticity, and a Babinski sign on this side; no changes in sensation were noted. There were ~ diopters of papilledema without retinal hemorrhage.