Fibromatosis colli
Updates to Article Attributes
Fibromatosis colli is a rare form of infantile fibromatosis that occurs within the sternocleidomastoid muscle.
Epidemiology
There may be a slight male predilection. ItFibromatosis colli typically presents a few weeks after birth. There may be a slight male predilection.
Clinical presentation
Presentation is usuallyInfants present with torticollis and. It is unilateral in most frequentlycases. On clinical examination, there may be a growing, hard neck mass 7.
Pathology
Fibromatosis colli is thought to be related to birth trauma (e.g. forceps delivery and difficult labour) or malposition (e.g. breech) in the womb. On clinical examination, there may be a growing, hard neck mass 7
Pathology
The importance of fibromatosis colli, above all else, is that it must be recognised for the benign lesion that it is. It is unilateral in most cases. It has been proposed that birth trauma leading to haemorrhage as a predisposing factor eventually results in fibrosis.
Radiographic features
The right sternocleidomastoid muscle is more commonly affected (73% of the time).
Ultrasound
Ultrasound is the imaging modality of choice. The sternocleidomastoid muscle is diffusely enlarged (but most involves the muscle belly) to assume a fusiform/ellipsoid shape/thickening with resultant shortening, therefore the chin is turned away from the affected side (the mastoid process is drawn inferiorly towards the ipsilateral head of clavicle). Echogenicity may vary in the affected fibrotic regions. Spectral Doppler interrogation may reveal a high resistance waveform. The enlarged area often moves synchronously with the rest of the sternocleidomastoid on real-time sonography 1, smoothly blending with the unaffected fibres. A discrete mass should not be seen. The presence of hyperechoic calcific foci suggests previous haemorrhage.
CT
Typically shows a diffusely enlarged sternocleidomastoid that is isoattenuating to normal neighbouring musculature. Adjacent fat planes are well preserved. At times, calcification may be present 2.
Treatment and prognosis
It is a self-limiting condition and usually resolves within 4-8 months 3 and requires no more than physiotherapy.
Differential diagnosis
For a general differential see: differential diagnosis of paediatric cervical lesions.
-<p><strong>Fibromatosis colli</strong> is a rare form of infantile <a href="/articles/fibromatosis">fibromatosis</a> that occurs within the <a href="/articles/sternocleidomastoid-muscle">sternocleidomastoid muscle</a>.</p><h4>Epidemiology</h4><p>There may be a slight male predilection. It typically presents a few weeks after birth.</p><h4>Clinical presentation</h4><p>Presentation is usually with <a href="/articles/torticollis">torticollis</a> and is most frequently related to <a href="/articles/birth-trauma">birth trauma</a> (e.g. forceps delivery and difficult labour) or malposition (e.g. breech) in the womb. On clinical examination, there may be a growing, hard neck mass <sup>7</sup>.</p><h4>Pathology</h4><p>The importance of fibromatosis colli, above all else, is that it must be recognised for the benign lesion that it is. It is unilateral in most cases. It has been proposed that birth trauma leading to haemorrhage as a predisposing factor eventually results in fibrosis.</p><h4>Radiographic features</h4><p>The right sternocleidomastoid muscle is more commonly affected (73% of the time).</p><h5>Ultrasound</h5><p>Ultrasound is the imaging modality of choice. The sternocleidomastoid muscle is diffusely enlarged (but most involves the muscle belly) to assume a fusiform/ellipsoid shape/thickening with resultant shortening, therefore the chin is turned away from the affected side (the mastoid process is drawn inferiorly towards the ipsilateral head of clavicle). Echogenicity may vary in the affected fibrotic regions. Spectral Doppler interrogation may reveal a <a href="/articles/doppler-waveforms">high resistance waveform</a>. The enlarged area often moves synchronously with the rest of the sternocleidomastoid on real-time sonography <sup>1</sup>, smoothly blending with the unaffected fibres. A discrete mass should not be seen. The presence of hyperechoic calcific foci suggests previous haemorrhage.</p><h5>CT</h5><p>Typically shows a diffusely enlarged sternocleidomastoid that is isoattenuating to normal neighbouring musculature. Adjacent fat planes are well preserved. At times, calcification may be present <sup>2</sup>.</p><h4>Treatment and prognosis</h4><p>It is a self-limiting condition and usually resolves within 4-8 months <sup>3</sup> and requires no more than physiotherapy.</p><h4>Differential diagnosis</h4><p>For a general differential see: <a href="/articles/paediatric-cervical-lesions-differential">differential diagnosis of paediatric cervical lesions</a>.</p>- +<p><strong>Fibromatosis colli</strong> is a rare form of infantile <a href="/articles/fibromatosis">fibromatosis</a> that occurs within the <a href="/articles/sternocleidomastoid-muscle">sternocleidomastoid muscle</a>.</p><h4>Epidemiology</h4><p>Fibromatosis colli typically presents a few weeks after birth. There may be a slight male predilection.</p><h4>Clinical presentation</h4><p>Infants present with <a href="/articles/torticollis">torticollis</a>. It is unilateral in most cases. On clinical examination, there may be a growing, hard neck mass <sup>7</sup>.</p><h4>Pathology</h4><p>Fibromatosis colli is thought to be related to <a href="/articles/birth-trauma">birth trauma</a> (e.g. forceps delivery and difficult labour) or malposition (e.g. breech) in the womb. Resulting haemorrhage eventually results in fibrosis. </p><p>The importance of fibromatosis colli, above all else, is that it must be recognised for the benign lesion that it is.</p><h4>Radiographic features</h4><p>The right sternocleidomastoid muscle is more commonly affected (73% of the time).</p><h5>Ultrasound</h5><p>Ultrasound is the imaging modality of choice. The sternocleidomastoid muscle is diffusely enlarged (but most involves the muscle belly) to assume a fusiform/ellipsoid shape/thickening with resultant shortening, therefore the chin is turned away from the affected side (the mastoid process is drawn inferiorly towards the ipsilateral head of clavicle). Echogenicity may vary in the affected fibrotic regions. Spectral Doppler interrogation may reveal a <a href="/articles/doppler-waveforms">high resistance waveform</a>. The enlarged area often moves synchronously with the rest of the sternocleidomastoid on real-time sonography <sup>1</sup>, smoothly blending with the unaffected fibres. A discrete mass should not be seen. The presence of hyperechoic calcific foci suggests previous haemorrhage.</p><h5>CT</h5><p>Typically shows a diffusely enlarged sternocleidomastoid that is isoattenuating to normal neighbouring musculature. Adjacent fat planes are well preserved. At times, calcification may be present <sup>2</sup>.</p><h4>Treatment and prognosis</h4><p>It is a self-limiting condition and usually resolves within 4-8 months <sup>3</sup> and requires no more than physiotherapy.</p><h4>Differential diagnosis</h4><p>For a general differential see: <a href="/articles/paediatric-cervical-lesions-differential">differential diagnosis of paediatric cervical lesions</a>.</p>
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