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

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.