Download - PSO-HNS

CLINICALFEATURES ORIENTALS NON-ORIENTALS
ageat onset 1st decade onsetin 3rd to
peakat 2nd
4th decades
and 3rd decades
sex 85% males rare in whites
pain and tenderness rare rare in whites
coexistentlymph- 40% incidence unusualin whites
denopathy increasedto 65%
with tumors > 2 cm
peripheralblood 60% incidence 17% of whites
eosinophilia
predominantsite pre-auricular, pre-auricular,
neck
scalp
scalp (rare)
neck (rare)
Our patient, a 24 year old male, first noticed Batsakis and Manning suggested radiotherapy
the lesion when he was 15 years of age. Tumor as a consideration in recurrent lesions.
mass was larger than 2 cm. with the presence of
cervical lymphadenopathy. There was involvement Kimura's is indolent and even self-limiting in
of the preauricular and neck area. Pain and some cases. However, there is a high incidence of
tenderness were not present. Except for the local recurrence or persistence of Kimura's that
absence of peripheral blood eosinophilia, our patient occur after various forms of treatment. Steroids
definitely belongs to the Oriental type of Kimura's. are given for systemic effect. The use of radiotherapy
for indolent benign disease, particularly in
Batsakis said that the initial stimulus for the younger patients is condemned. (Thompson et al)
lesion is unknown and since host responses with the
ethnic overlay may modify clinical expression, it is Our patient underwent three unsuccessful surgical
not impossible to regard the lesions as a fundamen- incisions. Radiotherapy as an alternate mode of
tal biologic reaction with different clinical and management would be unthinkable due to our
pathologic expression in different races, patient's young age. Because of these circumstances
steroid was tried. Prednisone was started at a dose
MANAGEMENT of 60 mg/day and it resulted in remarkable regression
of the mass in just one week. One year after,
Current available literature suggests different he is still free of disease, does routine work as
treatment modalities in the management of Kimura's if nothing happened to him. The tum of events
Disease. It has been treated with steroids and by was indeed dramatic for our patient who for the
surgical excision, irradiation, cryotherapy, and last nine years has endured the course and come:
electrodessication. According to Thompson, per- quences of the disease.
sistent residual disease and local recurrence are
frequent. He suggested laser excisions as a successful CONCLUSION
alternate mode of therapy with definite benefits over
those methods used commonly. Adequate surgical Soft tissue tumors of unusual forms in the head
excision seems to be the often treatment of choice and neck comprises a challenging group of pathologic
but the highly vascular nature of the ':lesion often conditions that cause difficulty in classification and
makes margins difficult to identify, treatment. This poses a great herculean challenge
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