the calcifying epithelial odontogenic tumor ( ceot ) is a rare benign tumor of the jaws first described by pindborg in 1955 and also referred as pindborg tumor . the clear cell variant of ceot was first reported by abrams and howell in 1967 . topographically two entities have been distinguished : intraosseous ( central ) and extraosseous ( peripheral ) . twelve central lesions have been reported of which only three cases have been reported in maxilla . typically , ceot has been described as slow growing , benign and locally aggressive tumor . hicks et al . , suggested that clear cell variant may show more aggressive behavior with higher recurrence ( 22% ) . clear cells are present as cellular components of the epithelial lining of lateral periodontal and gingival cysts in adults , or they may be found as clear - cell rests of the dental lamina within the connective tissue wall of these cysts . philipsen and reichart reviewed 181 cases of pindborg tumor , 15 of which are clear cell containing lesions . some authors have classified cceot as separate clinical entity . in this paper , a rare case of cceot of posterior maxilla is reported and clinical , radiographic histological features of the same are discussed . a 36-year - old indian woman reported to our department with painless , slow growing swelling of right upper jaw and loss of upper teeth due to mobility . the swelling was about 3  2 cm with normal color , intact mucosa and indentations of opposing tooth [ figure 1 ] . opg showed 3  3.5 cm mixed radiolucent - radiopaque lesion in the posterior maxilla with impacted teeth . radiographically  driven snow computed tomography ( ct ) revealed radiolucent - radiopaque mass in the right maxilla invading the cortex [ figure 3 ] . intra oral photograph showing solitary swelling in right posterior maxillary region snow - driven , radiolucent - radioopaque lesion seen in right maxilla in orthopantomogram computed tomography scan showing radiolucent - radiopaque mass in the right maxilla invading the buccal cortex an incisional biopsy was taken from the lesion . hematoxylin and eosin stained sections showed fibrous connective tissue stroma with islands of polyhedral epithelial cells containing nuclei of varying form and size . extracellular eosinophilic amyloid like material was found containing concentric calcifications in the form of liesegang rings [ figure 4 ] . initial histology sections showing liesegang rings ( h&e stain , 200 ) considering the age of the patient , esthetic concern and benign nature of ceot , curettage of the lesion along with the associated tooth was performed under general anesthesia ( ga ) . intranasal biopsy was performed , revealed clear cells in the stroma of ceot confirming the diagnosis of clear cell ceot [ figure 6 ] . recurrence evident in ct photomicrograph of intranasal biopsy showing liesegang rings and clear cells ( h&e stain , 100 ) clear cell variant of ceot is a rare entity and central cceot occurring in maxilla is rarest entity . an extensive review of literature on clinical and radiologic features of cceot has been done by anavi et al . equal distribution in males and females , age range of 14 - 68 years ; and of the 12 central lesions , nine involving the mandible and three in maxilla ( 75:25 ) have been reported . the typical clinical presentation of cceot is painless swelling of the jaw causing cortical expansion . radiological features of ceot is unilocular or multilocular lesion with mixed radiolucent and radiopacity of various density . clinical features and radiological features of the case presented are consistent with that of the other cceot reported . the three maxillary lesions described were radiolucent in opg , in the presented case lesion was typically of driven snow appearance . histological sections of ceot containing islands of polyhedral epithelial cells , having nuclei of varying form and size with extracellular eosinophilic material  amyloid and concentric calcifications within the connective tissue matrix in the form of liesegang rings are typical . clear cell variant consists of sheets or cords of clear cells with foamy cytoplasm in the matrix . these features were detected in the case presented confirming the diagnosis of clear cell variant . other variants of ceot described include pigmented , langerhan cells containing and non - calcifying variants . the clear cell variant tends to be more aggressive and shows higher recurrence rates than conventional ceot . the surgical management modalities in 19 reported cases were complete or partial resection in seven patients ( 37% ) , excision in seven ( 37% ) , enucleation in four ( 21% ) and curettage in one case ( 5% ) . waldron et al . , and hicks et al . , have reported that occurrence of the clear cells may prove to be a sign of increased tumor aggressiveness indicating a more radical approach . recurrence of tumor following curettage in our case strongly supports the data and enbloc resection is recommended . evidence supports that clear cell variant is a distinct entity , has more aggressive biological behavior and higher chances of recurrence . hence , it is important that presence of clear cells be included in histopathological diagnosis . the identification of clear cell directs the surgeon towards more definitive surgical excision of the lesion . maxillary lesions should be treated more aggressively because they grow faster and possess close proximity to important structures .