Sclerosing odontogenic carcinoma (SOC) is a primary intraosseous carcinoma of the jaw that was listed as a separate entity for the first time in the latest version of the World Health Organization classification of Head and Neck Tumors (2017). In this report, we present a case of SOC involving a circuitous diagnostic process because of the inadequately detailed biopsy findings and inherent impression based on the imaging manifestations. Through an extensive literature review, the histopathological and immunohistochemical features of the disease were briefly summarized. Radiological findings of SOC have been characterized in detail, and an imaging classification scheme has been proposed to further discuss the diversity of radiographic features. Due to the rarity of the disease, a comprehensive understanding of SOC is needed, and close collaboration between clinicians, radiologists, and pathologists is crucial to avoid misdiagnosis.

The present paper draw the attention of clinicians to investigate multiple slices of the computed tomography (CT) scan looking for a safe diagnosis of the so-called Garrè\'s osteomyelitis (GO) of jaws, a not uncommon disease characterized by astonishing bone growth. We report a case involving the left mandible of a 12-year-old girl presenting with a bony enlargement at left mandible. Initial examination revealed carious process of tooth 36 with radiographic apical rarefaction. However, we need to take care with this diagnosis because other aggressive diseases may cause bone enlargement mimicking GO. We observed here that careful examination of CT slices must be elucidative. In the present case, we observed the formation of a hypodense channel between periapical disease and the bone growth, through CT, thus supporting the pathophysiologic conditions for GO and allowing a safer decision to make the intervention restricted to tooth.