Fusion genes formed due to genomic instability have rarely been reported in osteosarcoma, with only Debelenko et al. reporting the discovery of a single EWSR1–CREB3L1 fusion gene in a small-cell osteosarcoma and Kang et al. reporting Rab22a–NeoF1 [12–14]. The gene discussed is CREB3L1; the disease is small cell osteogenic sarcoma.