CASE REPORT article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Primary Hepatic Osteosarcoma: A case report and literature review
Provisionally accepted
- 1Huangshi Central Hospital, Huangshi, China
- 2Taihe Hospital, Shiyan, China
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Background: Extra-skeletal osteosarcoma (ESOS) is an uncommon malignant soft tissue tumor, primarily seen in the soft tissues of the extremities or the retroperitoneal region. Primary hepatic osteosarcoma (PHO), a unique subtype, is clinically exceedingly rare. Thus far, only isolated instances have been documented in the literature, with limited high-quality study data accessible. Furthermore, there is no definitive clinical consensus regarding the ideal characterization and management of PHO. Case Presentation: This case report details a 67-year-old male patient hospitalized for one month due to abdominal pain. Upon admission, the patient displayed an increased serum alkaline phosphatase level. Computed tomography (CT) and magnetic resonance imaging (MRI) identified a well-defined lesion in the left hepatic lobe. The patient underwent an open left hemihepatectomy to obtain a conclusive diagnosis.Postoperative histological and molecular pathology assessments verified the tumor as a PHO. The patient underwent transhepatic arterial chemotherapy with epirubicin 30mg/m² and cisplatin 40mg/m², succeeded by 3 cycles of MAP regimen chemotherapy (methotrexate, doxorubicin, cisplatin) in conjunction with sorafenib-targeted therapy, achieving a recurrence-free survival (RFS) of 21 months. Conclusion: With a median age upon presentation of 61 years, PHO primarily affects men.It is identified radiologically by cystic-solid tumors, sometimes accompanied by calcifications, which facilitates early radiological detection. The literature analysis and our case report point to TP53 mutations and aberrant SATB2 expression as possible genetic markers that could close the diagnostic gap for this uncommon and frequently misdiagnosed illness. Preliminary findings indicate that multimodal therapies—surgery, chemotherapy, and targeted therapy—hold promise for improving patient survival despite PHO's high malignancy and poor prognosis.
Keywords: Osteosarcoma, Extra-skeletal, Liver, Pathological diagnosis, case report
Received: 19 Jul 2025; Accepted: 29 Nov 2025.
Copyright: © 2025 Luo, Yu and Xiao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Haiping Luo
Gaochun Xiao
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