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A 31-year-old Hispanic woman had a 3-year history of a steadily growing, increasingly pruritic, painless mass behind the right ear. The patient denied bleeding from the mass, ear pain, trauma, fever, fatigue, night sweats, or recent illnesses. Her medical history included eczema treated with triamcinolone acetonide cream. Otherwise, the patient had no family history or exposure to tobacco or alcohol.
On physical examination, a 2-cm, nontender, mobile retroauricular mass with superficial excoriations was palpable over the right mastoid cortex. The patient had no hearing deficits and no fistula into the external auditory canal. There was no palpable head and neck lymphadenopathy. Serologic studies revealed an elevated absolute eosinophil count of 790/μL (reference range, <700/μL; to convert to ×109 per liter, multiply by 0.001) and an eosinophilia percentage of 9.7% (reference range, <6.0%). The T1-weighted postcontrast magnetic resonance imaging of the head and neck showed a heterogeneously enhancing mass with irregular borders in the right retroauricular space, with a tract coursing anteriorly toward the parotid gland (Figure, A).
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C. Kimura disease
Kimura disease (KD) is a chronic inflammatory disorder of the salivary glands or lymph nodes of the head and neck. Recognized in 1948 as a distinct clinicopathologic entity, much of our knowledge of this disease comes from a collection of sporadic case reports and small case series. It is characterized clinically by unilateral, painless cervical lymphadenopathy and deep subcutaneous masses of the head and neck, systemic eosinophilia, and elevated serum immunoglobulin E levels. This disease typically occurs in young Asian male patients in their second to fourth decades of life, although rare cases in other races and ethnicities have also been seen.1 We report a case of KD in an adult Hispanic woman in the United States.
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Corresponding Author: Mark Swanson, MD, Caruso Department of Otolaryngology–Head and Neck Surgery, Keck School of Medicine, University of Southern California, 1540 Alcazar St, Ste 204M, Los Angeles, CA 90033 (email@example.com).
Published Online: October 31, 2019. doi:10.1001/jamaoto.2019.3246
Conflict of Interest Disclosures: None reported.
Additional Contributions: We thank the patient for granting permission to publish this information.
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