Diagnosis And Management Of Kimura Disease In Head And Neck

Objectives:The purpose of this study was to improve our understanding of the Kimura disease, particularly its clinical manifestations and response to different treatments, thus improving our abilities to diagnose and manage the disease.Methods:A retrospective study was carried out on20patients diagnosed with Kimura disease of head and neck in the department of Oral and Maxillofacial Surgery of the Second Affiliated Hospital, Zhejiang University School of Medicine between January1st,2009and January1st,2014. Clinical records and auxiliary examination data of the patients were retrospectively analyzed and, through return visit and telephone follow-up, their latest information, particularly whether there existed recurrence or not, was collected.Results:Kimura disease predominantly presented as an enlarging mass or multiple ones, which might be painless or painful, with a history of repeated swelling. There were complaint of itch in50%patients and pigmentation in20%patients. The routine blood test showed that Eosinophil absolute value rose in75%patients and its percentage rose in90%patients. Kimura disease was hardly distinguishable on ultrasound, CT or MRI from other diseases like hemangioma, inflammatory lesions, Warthin’s tumor, pleomorphic adenoma mixed tumor, and even malignant tumors. A clear diagnosis of Kimura disease was preoperatively made in only55%patients. In terms of its treatment, Kimura disease had positive response to surgery, radiation therapy and comprehensive therapy as well. Steroidal medication seemed valuable, yet rebound effect existed. Recurrence was found in25%of the patients.Conclusion:When there is a painless mass in head and neck suspected to be Kimura disease, itch and pigmentation may be indicative, yet rise of Eosinophil absolute value and its percentage in blood is more valuable to the diagnosis. Kimura disease is sensitive to surgery, radiation therapy and their combination. But there exists the risk of recurrence.