Two-Stage Conservative Management of Mandibular Unicystic Ameloblastoma with an Intraluminal Pattern: A Case Report

Intraluminal unicystic ameloblastoma is characterized by tumor proliferation confined to the cystic lumen, without invasion of the supporting connective tissue, a feature that has led some authors to regard it as particularly suited to conservative surgical treatment. Objective: This study aims to describe the conservative two-stage management of a mandibular unicystic ameloblastoma with an intraluminal pattern, treated by decompression followed by enucleation with the aim of avoiding mandibular resection. Case Report: A 24-year-old female patient presented with a slight swelling in the right mandibular angle that had evolved over two years without prior treatment. Panoramic radiography revealed a well-defined radiolucent lesion extending from the mesial surface of the right mandibular second molar through the mandibular ramus to the ipsilateral coronoid process. Cone-beam computed tomography (CBCT) confirmed the lesion as a hypodense area measuring approximately 6 × 3.4 × 2.9 cm. A two-stage surgical approach was performed: the first stage consisted of an incisional biopsy and the placement of a decompression tube for six months; the second stage consisted of enucleation of the lesion. The definitive histopathological diagnosis was intraluminal unicystic ameloblastoma with a plexiform growth pattern. The surgical procedures were completed without preoperative, intraoperative, or postoperative complications. Follow-up evaluations were performed at 3 and 6 months and at 1 and 2 years after the initial surgical stage. Conclusions: At 24 months from the initiation of treatment, the outcome was favorable, with evidence of mandibular bone apposition and no signs of lesion recurrence.