July 27, 2009

Fibromatosis Colli of Infancy

Transverse ultrasound images of the right sternocleidomastoic (SCM) muscle and left (symptomatic side) shows diffuse enlargement of the left SCM with mixed echogenicity in a 2-month-old infant.

Facts: Fibromatosis Colli of Infancy
  • Abnormal mass-like enlargement of sternocleidomastoic (SCM) muscle
  • Born normal but develops SCM mass and/or torticollis within the first 4-8 weeks of life
  • Associated with difficult delivery and intrauterine torticollis due to malposition
  • Histology: collagen fibers and fibroblasts around atrophied muscle fibers
  • Early diagnosis and treatment important because it can result in contracture
  • Responds well to physiotherapy
Ultrasound Appearance
  • US performed to exclude other diagnosis such as cervical lymphadenopathy, rhabdomyosarcoma, lymphoma, cystic hygroma or branchial cleft cyst
  • Mass or fusiform enlargement of the SCM muscle
  • Confined to muscle, no adjacent abnormalities of other soft tissues
  • Variable echogenicity -- hyperechoic, hypoechoic, or mixed echogenicity
Bedi DG, John SD, Swischuk LE. Fibromatosis colli of infancy: variability of sonographic appearance. J Clin Ultrasound 1998;26:345-348.

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