Kimura's Disease of Orbit and Elbow in an Asian Child-A Case Report

目的：報告一例罕見發生於亞洲小孩之眼窩及手肘雙重病灶Kimura氏病，並以類固醇及azathioprine治療成功。方法：病例報告。結果：一位十歲男孩發現在最近一年來左眼突出且左上眼皮腫脹，但無複視或是疼痛的現象，全身檢查時發現右手肘亦有一無痛之腫塊，且有右腋「及左頸部淋巴結腫大。斷習掃描顯示左眼下直肌腫脹及淚腺腫瘤，右手肘有一合併淋巴結侵犯之腫塊。他接受右手肘腫塊及右腋下及左頸部淋巴結切除手術，病理報告診斷為Kimura氏病，他並未接受左眼窩腫塊或下直肌切片手術，只接受口服類固醇起始劑量每天60毫克及azathioprine每公斤體重l毫克的治療六個月後，左眼突出及上眼皮團倀均獲得完全緩解。結論：我們報告一例罕見發生於小孩的雙重Kimura氏病，提醒眼科醫師在遇到眼窩腫瘤時亦須做全身性的整合評估，檢視是否有合併其他部分腫塊，以幫助深部眼窩腫瘤之診斷。手術治療時須考量長期併發症產生，而避免不必要的手術。

關鍵字

無資料

並列摘要

Purpose: To report a rare case of Kimura's disease occurring in the orbit and elbow in an Asian child. Method: Case report. Result: A 10-year-old boy presented with progressive protrusion of the left eye for one year without diplopia. His left upper eyelid was swollen, but painless. A second swelling lesion was noted over the right elbow. Orbital computed tomography (CT) revealed left lacrimal gland and lateral rectus muscle enlargement. Right elbow mass magnetic resonance imaging (MRI) showed high signal intensity of the infiltrative strands over soft tissue and enlarged lymph nodes. He received excision of the right elbow mass and lymph nodes of right axillary and left cervical region and the histopathological examination revealed Kimura's disease. Instead of receiving excision of the left orbital mass, he was treated with oral steroid and azathioprine for six months. Proptosis was improved, and MRI showed complete remission of orbital mass. Conclusion: In this rare case of double-lesion Kimura's disease, biopsy of the subcutaneous lesion helps the diagnosis of mass in deep orbit. We remind the ophthalmologist that a complete systematic evaluation should be made, which may help diagnosis of orbital tumor. Unnecessary surgical intervention should be avoided in the cases of benign orbital tumor.

並列關鍵字

Kimura's disease ； orbit ； children ； proptosis

國際替代計量

Kimura's Disease of Orbit and Elbow in an Asian Child-A Case Report

全文下載

主題瀏覽