A benign tumor of substantial size: Mandibular epithelioid osteoblastoma in a socioeconomically challenged patient

Epithelioid osteoblastoma (EOB) is a rare, benign bone tumor characterized by the proliferation of atypical epithelioid osteoblasts within a vascular stroma. It typically presents as a slow-growing painful mass and requires careful differentiation from more aggressive lesions like osteosarcoma for appropriate management. We present a case of an otherwise healthy 30-year-old man who presented with a mandibular EOB measuring 23 cm × 17 cm x 19 cm, causing significant disfigurement and functional impairment. Surgical management involved radical resection and immediate reconstruction using an osteocutaneous fibula free flap. The case emphasizes the importance of multidisciplinary care, advanced surgical planning, and the impact of socioeconomic factors on healthcare access and outcomes. •Largest documented mandibular EOB at 23.5 cm with delayed diagnosis.•Use of VSP for precise surgical planning and reconstruction.•Complex resection with fibula free flap reconstruction.•Case emphasizes the impact of socioeconomic factors on delayed care.•Multidisciplinary approach vital for managing large bone tumors.