Kimura disease masquerading as soft tissue tumor of the elbow

Abstract

Kimura disease is a rare chronic inflammatory disorder of unknown etiology, characterized as painless subcutaneous mass which is rarely found outside head and neck region. We report an unusual presentation of Kimura disease of a 50-year-old man who presented with a progressive large non-tenderness right elbow mass for one year. Physical examination revealed a 10 cm soft tissue mass at the medial side of his right elbow. The Laboratory investigation showed peripheral eosinophilia. The clinical diagnosis was a soft tissue tumor. It also included the differential diagnosis of a parasitic infection. Surgical excision had been performed and the histology demonstrated a nodular lymphoid hyperplasia with prominent germinal centers, a large infiltration of eosinophils with a foci of eosinophilic micro-abscess and vascular proliferation which compatible with Kimura disease. Following surgery the patient visited again with the following symptoms, a left post auricular mass with multiple cervical lymph node enlargements. The excisional biopsy revealed the same histology as the elbow.