Kimura's disease sequentially involving multiple sites in the head and neck: A case report with a 13-year follow-up and literature review.

Abstract

Kimura's disease is a rare, chronic inflammatory condition with a high recurrence rate, primarily affecting young to middle-aged Asian males. It typically manifests as masses in the head and neck, accompanied with regional lymphadenopathy. This report describes the case of a 50-year-old man initially diagnosed with Kimura's disease 13 years ago, following surgical removal of a left submandibular mass. Subsequent recurrences involved the parotid and contralateral submandibular regions, requiring radiotherapy and intermittent oral prednisone therapy. After 6 years, he developed progressive proptosis and visual impairment, revealing multiple orbital masses bilaterally. A puncture examination of the left submandibular mass was indicative of Kimura's disease. Throughout the follow-up period, the eosinophil levels correlated with prednisone use. This case highlights the disease's capacity for multisite recurrence within the head and neck over an extended duration. The extensive orbital involvement without renal manifestations is a rare presentation. Long-term follow-up is crucial in Kimura's disease management, and oral prednisone can effectively control disease progression.