**1. Introduction**

Osteosarcomas (OS) are the most frequent primary malignant tumor arising in the bone, formed by neoplastic cells that synthesize and secrete organic components of the bone matrix, which may or may not be mineralized [1]. It usually affects long bones, occurring in the craniofacial area in only 6–10% of cases and accounting for less than 1% of all head and neck cancers [2–5]. However, it has a unique clinical behavior, different from OS in other parts of the body, which grants head and neck osteosarcoma (HNOS) a distinctive prognosis. This makes it a subject that should be reviewed separately. However, given its infrequency, the evidence we have on the subject is scarce, mostly based on retrospective studies and case series, and most of its management approaches are extrapolations of the treatment established for long bones OS.
