Clinical Paper
Clinical Pathology
Comparison of the efficacy of different treatment modalities for Kimura's disease

https://doi.org/10.1016/j.ijom.2016.08.013Get rights and content

Abstract

The objective of this study was to investigate the clinical features of Kimura's disease in the head and neck region and to compare the local recurrence rate between three therapies used for the treatment of this disease. The clinicopathological information of 46 hospitalized patients suffering from Kimura's disease in the head and neck region over a 10-year period was reviewed retrospectively. All lesions were clinically observed in the head and neck region. These 46 patients underwent a total of 58 treatments; nine patients underwent multiple treatments due to local recurrence. Of the 58 treatments, 32 involved surgical excision alone, 24 involved surgical excision and postoperative low-dose radiotherapy (20–40 Gy), one was a combination of ultrasound-guided core needle biopsy and radiotherapy, and one was a combination of incisional biopsy and subsequent radiotherapy. During the follow-up period, nine patients suffered 16 local recurrences. The recurrence rate of surgical excision combined with low-dose radiotherapy was much lower than that of surgical excision alone or radiotherapy alone (both P < 0.05). It is concluded that Kimura's disease is a benign condition with a good prognosis, and surgical excision combined with postoperative low-dose radiotherapy is associated with the lowest local recurrence rate in the treatment of this disease.

Section snippets

Patients and methods

Over a 10-year period (2004–2013), 46 patients with a clinicopathological diagnosis of Kimura's disease were treated at the study institution. Detailed clinical data were retrieved from the patients’ medical charts, including sex, age, site involved, clinical duration, laboratory workup, treatment modality, and pathological diagnosis. Demographic information and details of these patients were analyzed. The clinical management of these cases was summarized, including the use of surgical

Clinical characteristics

Out of the 46 patients examined, 40 were male and six were female, giving a male-to-female ratio of 6.7:1. The age at onset ranged from 5 to 78 years (median age 41 years). With regard to the anatomical distribution, 23 cases (50%) involved the parotid region (six cases involved the bilateral parotid regions), 14 cases involved the submandibular region, and six cases involved multiple regions. Twenty-nine patients developed a solitary lesion of Kimura's disease. The remaining patients

Discussion

Kimura's disease is a rare and chronic inflammatory lesion with a peak incidence during the second and fourth decades of life; approximately 80–87% of patients are men.4 Clinically, in the present series, the median age at onset of Kimura's disease was 41 years, consistent with the onset reported in the literature (second and fourth decades).3 Forty of the 46 patients in this series were men, giving a male-to-female ratio of 6.7:1. This is similar to the sex distribution reported in a previous

Funding

This study was supported by the National Supporting Program for Science and Technology of China (No. 2014BAI04B06).

Conflict of interest

The authors do not have any conflicts of interest.

Ethical approval

Ethical approval was not required for this study.

Patient consent

Written patient consent was obtained to publish the clinical photographs.

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© 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.