From Innocuous to Aggressive: A Case of Odontogenic Keratocyst Transforming to Unicystic Ameloblastoma

Odontogenic keratocysts are known for their aggressive and recurrent nature. Clinically and radiographically distinguishing between ameloblastoma and odontogenic keratocysts can be challenging due to their similar locations, age of affected patients, and multilocular appearance. Ameloblastomas co-occurring with odontogenic cysts or other odontogenic lesions have been documented as combined lesions. However, unique incidences of odontogenic keratocysts showing changes of unicystic ameloblastomas are scarce, especially a large aggressive lesion occurring in the mandible extending from the molar-to-molar tooth region in a young patient as presented in this case. This transformation is rare and intriguing and warrants detailed exploration and documentation. Considering the rarity of the lesion, this case highlights the importance of considering the aggressive nature of the lesion and its transformation into ameloblastoma, cautioning the surgeon to have a long-term follow-up to evaluate recurrence and emphasizing the regeneration and restoration of quality of life in young patients.