Osteosarcomas predominantly manifest in the long bones of the extremities, with rare occurrences in the skull. A case involving of a 53-year-old female who presented to the authors’ hospital for examination due to dizziness was incidentally found to have an occipital bone mass, which was initially diagnosed as a benign tumor and did not receive sufficient attention. Two years later, owing to tumor enlargement, the patient underwent further evaluation at the same institution, which revealed evidence of occipital bone destruction. Pathological analysis confirmed the diagnosis of osteosarcoma. The patient underwent surgical resection followed by radiotherapy. Despite its infrequency and uncharacteristic initial presentation, skull osteosarcomas should not be overlooked.
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