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]. Here, RAB22A is linked to small cell osteogenic sarcoma.