Kimura Disease in a Saudi Female: A Rare Mimicker of Malignancy with Multifocal Head and Neck Involvement

Kimura disease (KD) is a rare chronic inflammatory disorder typically affecting young Asian males, making its occurrence in a middle-aged Saudi female highly unusual. We report the case of a patient with a history of multinodular goiter who developed recurrent right parotid swelling and was initially misdiagnosed with Hodgkin lymphoma following the incidental discovery of an epiglottic mass. Subsequent evaluation, including histopathological and immunohistochemical analyses of parotid and cervical lymph node biopsies, revealed features consistent with KD, such as reactive lymphoid follicles, eosinophilic infiltration, and vascular proliferation. Laboratory findings showed elevated eosinophil counts and markedly high IgE levels. Treatment with corticosteroids and mycophenolate mofetil resulted in complete resolution of symptoms with no recurrence. This case underscores the need to consider KD in the differential diagnosis of head and neck swellings, particularly in atypical populations, and highlights the importance of thorough pathological evaluation to avoid misdiagnosis.