Innocent Swelling to Tumor Diagnosis: A Case of Unicystic Ameloblastoma

AbstractIntroduction: Unicystic ameloblastoma is a relatively less aggressive variant of ameloblastoma that commonly occurs in the posterior region of the mandible. It is often seen in younger individuals with typically occurring between 10-30 years and may present as a painless swelling or may even be detected incidentally during routine radiographic examination. As the lesion expands, it may cause facial asymmetry, pain, displacement of teeth, and occasionally loosening of nearby teeth. The role of Oral Medicine and Radiology in managing such cases mainly focuses on thorough clinical examination, appropriate radiographic evaluation, and working closely with the surgical team for proper treatment planning.Presentation of case: A 28 year old male patient complains of swelling in lower right back tooth region since 2 months. Intraoral examination shows a mild tender swelling extending from 32 to 47 region. Radiographic examination showed a well-defined, multilocular radiolucency associated to teeth 32 to 47. Initial diagnosis was made as acanthomatous ameloblastoma and excisional biopsy was performed. Final diagnosis was an Unicystic Ameloblastoma.Discussion: The unicystic variant of ameloblastoma (UA) is considered one of the least frequently encountered forms of ameloblastoma. It tends to occur more often in the posterior region of the mandible than in the maxilla. When a radiolucent lesion is seen on imaging, particularly if it is associated with an impacted tooth, establishing a clear differential diagnosis can be difficult. Treatment planning becomes even more complex in younger patients, as aggressive surgical procedures may lead to significant functional and aesthetic consequences. In this case, a conservative management approach was chosen. This strategy helped minimize complications while preserving the developing permanent teeth and maintaining as much of the surrounding bone as possible, thereby reducing the risk of facial deformity.Conclusion: This case report highlights the important role of thorough clinical examination and radiographic evaluation in identifying cases of UA where a conservative treatment approach may be suitable. Such an approach is especially advantageous in younger patients, as it helps preserve the associated tooth and maintain the surrounding alveolar bone while avoiding unnecessarily aggressive surgical procedures , most often in the posterior mandible. Patients usually notice a painless enlargement of the jaw that gradually increases in size over time. As the lesion expands, it may cause facial asymmetry, displacement of teeth, and occasionally loosening of nearby teeth clinically as a slow-growing swelling of the jaw, most often in the posterior mandible. Patients usually notice a painless enlargement of the jaw that gradually increases in size over time. As the lesion expands, it may cause facial asymmetry, displacement of teeth, and occasionally loosening of nearby teeth.