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Fibromatosis Coli
Case Detail
| Anatomy: Neck-Face |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Trauma |
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| Created: over 3 years ago |
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| Updated: over 2 years ago |
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| Tags:
PEDS
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| Modality/Study Types:
US
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Activities:  PDF  ImageJA |
History
7 week old female with torticollis and right-sided neck mass.
Case Images
Diagnosis
Fibromatosis Coli
Findings
US – Longitudinal and transverse images of the right sternocleidomastoid muscle demonstrate globular enlargement with heterogeneous signal centrally. Note the normal fusiform shape and striated appearance of the left sternocleidomastoid muscle.
Discussion
Fibromatosis colli is a benign fibroblastic proliferation typically involving the sternocleidomastoid muscle; rarely the trapezius muscle is involved. It manifests as a mass with torticollis between 1 and 15 weeks of age. It is most often right sided and ususally related to birth trauma (pressure necrosis or venous obstruction leading to edema, muscle fiber degeneration and fibrosis).
Fusiform thickening and shortening of the muscle results in ipsilateral tilting and rotation of the head. Facial asymmetry and plagiocephaly may also be seen. Associated abnormalities include foot anomalies, hip dysplasia, scoliosis and neurologic deficits/seizure.
Lesions usually resolve spontaneously. Physical therapy consisting of gentle stretching may be necessary in some cases. Refractory cases may require surgery or botox injection. Occasionally, torticollis recurs in adulthood.
Reference
Murphy MD, et al. Musculoskeletal fibromatoses: Radiologic-pathologic correlation. Radiographics (2009); 29(7):2143-2176.