Decompression, an Unusual Treatment Option for Multicystic Ameloblastoma: Concepts and Controversies

Background: The most common odontogenic tumor is the solid ameloblastoma. This is concerning due to the progressive bone destruction in its intraosseous variant; this type of pathology often gets a delayed diagnosis due to the asymptomatic characteristic it has. Objective: The aim of the article is to propose a conservative treatment for multicystic ameloblastoma, reviewing the latest concepts, controversies, and treatment options described in the literature. Case Report: A patient arrives to our department with a diagnosis of unicystic ameloblastoma, so decompression and subsequent enucleation were decided as treatment. However, the new histopathological result was a multicystic ameloblastoma; with this result, we decided to continue with the initial treatment, which in fact had an adequate response. A 5-month radiographic follow-up was performed in which a decrease in size was evident and enucleation was decided. The postoperative results were favorable after a 2.5-year follow-up. Conclusion: The solid ameloblastoma may have a cystic component, in which there is the possibility of diagnostic errors when studying an incisional biopsy; for this reason, the definitive diagnosis should be established until complete enucleation of the lesion is performed. This characteristic in a solid ameloblastoma makes possible a positive response to decompression, making it easier to perform the enucleation subsequently, avoiding other aggressive treatments that can dramatically affect the patient's quality of life and also avoiding costly reconstruction bills.