Kimura’s Disease Mimicking Neurofibroma: A Rare Presentation Along the Spine

BACKGROUND: Kimura’s disease, characterized by chronic inflammation and subcutaneous masses primarily in the head and neck region, is a rare entity. A poorly defined subcutaneous mass showing high signal intensity on T1 and T2 weighted magnetic resonance imaging (MRI) with homogenous enhancements and peripheral eosinophilia should raise suspicion for this rare entity.CASE PRESENTATION: We present the case of a 40-year-old male presenting with bilateral lower limb pain along the lumbar 4 and lumbar 5 (L4 L5) distribution, with MRI initially suggestive of a neurofibroma. However, histopathological analysis revealed Kimura’s disease, an unusual presentation in the spine. To our knowledge, this represents the second reported case of Kimura’s disease in an adult affecting the spine and mimicking a neurogenic tumor. Treatment of this disease includes surgical excision of the mass, steroids, radiation and immunosuppressive therapy. These delay the disease progression as recurrences are common with Kimura’s disease.CONCLUSION: This case underscores the importance of comprehensive systemic examination and clinical acumen, particularly when encountering local lymph node involvement and laboratory findings of an inflammatory response.