A Case of Kimura Disease: Pitfalls in Parotid Gland Surgery

Kimura disease, which was initially described by Kimura et al. in 1948, is a rare entity that occurs primarily in Asian people characterized histopathologically by a lymphofolliculoid granuloma with infiltration of the mass and the surrounding tissue by eosinophils, often with concomitant peripheral blood eosinophilia and elevated serum Ig E. The kimura disease frequentlly involves head and neck region and reraly extrimities. When the disease involvews parotid gland, it is very difficult to differentiate clinically with parotid gland tumor. We have experienced a case of Kimura disease. The lesion was initially diagnosed as a parotid gland due to extensive fibrosis surrounding the mass. So, the mass excision was performed without clear identification of the facial nerve. The Kimura disease usually follows a benign course. But when this disease is confused with parotid gland tumor, there will be a danger of nerve injury due to difficulty in dissection of the extensive fibrotic soft tissue surrounding the parotid gland.