Radiographic Multilocularity as a Predictor of Histologic Aggressiveness in Unicystic Ameloblastoma: Two Case Reports and a Literature Review

Abstract

Unicystic ameloblastoma (UA) is a distinct clinicopathological variant of ameloblastoma characterized by a cystic architecture and comparatively less aggressive biological behavior than conventional solid or multicystic ameloblastoma. Despite its generally favorable prognosis, significant variability exists in its histological presentation and clinical behavior. Radiographic characteristics have long been considered important diagnostic indicators; however, the relationship between radiographic multilocularity and histologic aggressiveness remains incompletely understood. This review-based research article evaluates the potential correlation between multilocular radiographic appearance and aggressive histopathological patterns in unicystic ameloblastoma through the analysis of two representative cases and a comprehensive review of existing literature. The article synthesizes evidence regarding radiographic manifestations, histological subtypes, biological behavior, recurrence tendencies, and treatment implications. Literature demonstrates that while unilocular radiographic presentation predominates in unicystic ameloblastoma, multilocular lesions frequently exhibit mural invasion and more aggressive microscopic characteristics. Histopathological evaluation remains the gold standard for diagnosis; however, radiographic multilocularity may serve as a valuable preoperative indicator of biological aggressiveness. Recognition of this association may facilitate improved treatment planning, risk stratification, and long-term clinical outcomes. The study highlights the necessity for integrated radiologic-pathologic assessment in the management of unicystic ameloblastoma.