Ameloblastoma com atipia: desafio diagnóstico

Abstract

Ameloblastoma is a benign but locally invasive odontogenic tumor that presents diagnostic challenges when associated with atypical histological patterns. This study aims to report the case of a 27-year-old female patient with a lesion involving an impacted tooth in the left maxillary sinus region, addressing the diagnostic challenges and the criteria that guided the clinical approach. Initially, the diagnostic hypothesis was a dentigerous cyst or odontogenic keratocyst, later ruled out after an incisional biopsy. Histopathological examination revealed areas of atypia and hypercellularity, raising the suspicion of ameloblastic carcinoma, a rare malignant neoplasm with high metastatic potential. Following detailed investigation, the final diagnosis was ameloblastoma with atypia, as no sufficient criteria compatible with malignancy were observed. The proposed treatment involved lesion excision, followed by curettage and cryotherapy. This study highlights the importance of detailed analysis of clinical, imaging, and histopathological data to avoid unnecessary radical treatments, ensuring proper management and a favorable prognosis for the patient.