Aggressive osteoblastoma of the maxilla-a diagnostic conundrum

Osteoblastomas are biologically benign tumors with limited growth potential and may show a wide range of clinical, radiographic and histopathological findings. Osteoblastomas of the jaw may resemble other gnathic lesions including osteoid osteoma, cementoblastoma, cement-ossifying fibroma, cemento-osseous dysplasia and osteosarcoma, offering a unique diagnostic conundrum. Aggressive osteoblastoma, a rare variant of osteoblastoma characterized by the presence of atypical histopathological features like epithelioid osteoblasts and exhibiting locally aggressive behavior is rarely reported in the jaw bones. The accurate diagnosis and delineation of this entity from malignant bone tumors sometimes may be a challenge. The case report emphasizes this entity, which has to be differentiated from low- grade osteosarcoma and highlights the gravity of clinico-pathologic correlation in such lesions.