Clear cell odontogenic tumors are uncommon, only 20 cases having been repor
ted in the literature. We report a case that presented with unique radiogra
phic manifestations over a period of 12 years; no similar case has been rep
orted to date. Documentation of the malignant nature of the condition and o
f the range of clinical and radiographic manifestations with which this neo
plasm can present provides useful insight into its pathogenesis and progres
sion. Early and timely recognition of the lesion, histopathologic examinati
on, and aggressive interventional procedures are in order to successfully t
reat this condition and prevent a potentially fatal outcome.