Osteosarcomatosis (also known as multifocal osteosarcoma or multiple sclero
tic osteosarcoma) is a rare condition, characterized by multiple skeletal l
esions at initial presentation. We describe a case of osteosarcomatosis inv
olving craniofacial bones presenting with cranial nerve palsies. In additio
n, a brief review of the literature is given, with a discussion of this hig
hly aggressive form of osteosarcoma.