Diffuse large B-cell lymphoma is an aggressive, fast-growing form of non-Hodgkin disease with rare manifestation in mandible as a primary site. Absence of pathognomonic features in this localization often leads to misdiagnosis as an odontogenic process or its delayed diagnosis. The present case report is of a patient in whom non-odontogenic jaw pain mimicked a toothache prompting multiple dental interventions before persistence of pain and atypical findings led to consideration of a primary malignant etiology. Keywords: diagnostic challenge, jaw malignancy, oral medicine, pathology, radiology