Kimura's disease of the right cheek: A case report

Abstract

Abstract. Kimura's disease (KD), a chronic inflammatory disease of uncertain etiology, manifests as a painless subcutaneous swelling in the head and neck region that involves major salivary glands and regional lymph nodes. To date, the majority of cases of KD have been documented in Asian males aged 20-30 years. However, the number of reported cases of KD involving the oral and maxillofacial area is limited, and since the masses appear similar to cysts or benign tumors, the establishment of an accurate pre-operative diagnosis is challenging. The accurate diagnosis of KD is considered to require surgical excision followed by histopathological examination. In the current case, a 39-year-old man was admitted to hospital in October 2011 with a swelling evident on his right cheek. Surgical excision was performed, and histopathological observation was carried out. The formation of a lymphoid nodule accompanied by the vigorous proliferation of small blood vessels, eosinophilic infiltration and thickened cell walls were observed. No sign of recurrence of the mass has yet been observed, on the basis of the telephone follow-up interviews. These findings provide a novel insight useful in the diagnosis of KD in the oral and maxillofacial area. IntroductionKimura's disease (KD), a chronic inflammatory disease characterized by slowly growing subcutaneous nodules and benign reactive lymphoid proliferation in the face and neck region is predominantly observed in young Asian men (1). It is considered to be a benign disease involving subcutaneous tissues, major salivary glands and lymph nodes in the area of head and neck (2). Although numerous researchers have conducted investigations into the etiology of KD (3-5), reports concerning the underlying etiology of KD in oral and maxillofacial areas are limited (6). Until recently, the underlying cause of KD was unknown (7) In addition, the diagnosis of KD prior to surgery has proven challenging, since a clinical examination alone may not give an accurate diagnosis (8). In the present study, a case of KD affecting the oral and maxillofacial areas was evaluated and the corresponding pathogenesis was reported. Case reportThe patient in the present case was an otherwise healthy 39-year-old man. The patient was admitted to the Shanghai East Hospital Affiliated with Tongji University (Shanghai, China) in October 2011 with an obvious swelling on his right cheek (Fig. 1A). The patient had a 2-year history of non-painful swelling of the right-side cheek without additional symptoms. Three weeks prior to presentation, the patient sought medical attention and self-treated with an anti-bacterial agent administered orally (the name and dose of the drug are unknown). After a 3-week treatment, the mass only minimally responded to over-the-counter medication and no improvement in the patient's condition was exhibited. Therefore, the patient was referred to our hospital for further evaluation and treatment. According to the investigation conducted at the hospital, there was no history of recent febril...

Kimura disease: a rare cause of a recurrent cheek mass in a Jamaican man

“…The use of radiation therapy alone has been shown to have local recurrence rates of up to 75%; however, when used as an adjunct to surgery, recurrence rates are significantly less when compared with either treatment modality as a single entity, and it is now generally accepted that surgery followed by low dose radiation offers the longest periods of remission [ 5 , 6 , 8 ].…”

Treatment of Kimura disease with mycophenolate mofetil monotherapy

“…Treatment modalities reported in the literature are heterogeneous, but surgical excision and oral corticosteroids represent the most frequently used strategies. 3 , 5 Recurrence is common, especially when tapering steroids. 4 , 6 Leflunomide in combination with oral corticosteroids has shown promise in treating cases of KD refractory to steroids alone.…”

“…Therapeutic modalities for KD include surgical excision, radiotherapy, and various immunomodulating agents, such as oral corticosteroids, cyclosporine, and leflunomide. 1 , 3 , 4 , 5 , 6 , 7 Most cases have favorable initial responses to treatment, but relapse occurs at rates as high as 60% to 100%. 4 , 5 , 6 We report a case of KD with sustained response to mycophenolate mofetil (MMF) monotherapy.…”