# Rare Bilateral Symmetrical Kimura Disease: Diagnostic Challenges and Treatment Success in a 63-Year-Old Male Patient

## TL;DR

A rare case of Kimura disease in a 63-year-old man with bilateral neck masses was successfully diagnosed and treated after a 30-year history of symptoms.

## Contribution

Highlights the diagnostic challenges and successful treatment of a rare bilateral presentation of Kimura disease in an older patient.

## Key findings

- Bilateral retroauricular masses with pruritus and skin hyperpigmentation were confirmed as Kimura disease via histopathology and MRI.
- Successful treatment was achieved through surgical excision and corticosteroid therapy.
- Emphasizes the importance of considering KD in chronic bilateral neck masses with eosinophilia.

## Abstract

Kimura disease (KD) is a rare chronic inflammatory disorder that presents with eosinophilic infiltration and angiolymphoid proliferation, often affecting young men. However, its clinical manifestations can be elusive, especially when presenting bilaterally, which is exceptionally rare. This case report details a 63-year-old male patient with a 30-year history of progressive bilateral retroauricular masses, pruritus, and skin hyperpigmentation, a presentation that posed significant diagnostic challenges. Magnetic resonance imaging (MRI) revealed poorly defined, heterogeneously enhancing masses and bilateral cervical lymphadenopathy. The diagnosis was confirmed through histopathology and peripheral eosinophilia. The patient was successfully treated with surgical excision and corticosteroid therapy. This case underscores the importance of considering KD in the differential diagnosis of chronic, bilateral neck masses, particularly when accompanied by eosinophilia, and highlights the role of imaging and histopathology in accurate diagnosis.