A 68-year-old female with a history of head and neck radiation therapy (2 years prior) presents with a diffuse, mixed osteolytic and osteoplastic lesion of the right mandible, with ill-defined borders. The lesion extends from the right ramus to the midline, causing cortical perforation and destruction, as well as reactive periosteal bone formation. These features are highly suggestive of late-stage Osteoradionecrosis (ORN).