A 23-year-old man presented with left ptosis and periorbital swelling 4 years after concurrent chemoradiotherapy for his nasopharyngeal carcinoma. MRI revealed a 15 cm tumor in left hemiface. Craniofacial resection 01 the tumor was performed and showed a high-grade osteosarcoma. The tumor cells were negative for Epstein-Barr virus (EBV) by EBV-encoded small RNA in situ hybridization. Radiation-induced sarcoma should be considered in a previously irradiated patient even with relatively short latent period.