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    Go to the top of the page   ID: 20050603161131 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Fibromatosis colli - sternocleidomastoid pseudotumor of infancy
    Fritz Schneble. Fibromatosis colli - sternocleidomastoid pseudotumor of infancy. PedRad [serial online] vol 5, no. 6.
    URL: www.PedRad.info/?search=20050603161131


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Fritz Schneble (Regensburg)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    6 Weeks  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    Neck-Muscular system / Connective tissue / Skin  

     
     Pediatric Radiology CasesMost likely etiology:

    unknown  

     
     Pediatric Radiology CasesHistory:

    6 week old boy. For about 1 week, the parents noticed a hard, painless, non-warm swelling of about the size of a walnut on the right side of the neck.
    Patient history includes: Cesarean section due to breech position, otherwise unremarkable. Head position tends to be more to the left, although movement is unremarkable.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    The cause of sternocleidomastoid pseudotumor of infancy is unknown. The old name, "Head-nick hematoma" refers to the original idea that the this tumor was caused by trauma to the sternocleidomastoid muscle during birth. Often, one finds a difficult delivery (vacuum extraction or forceps) in the history. In the typical case, 2-4 weeks after birth, the child develops a hard, painless nodule in the region of the middle sternocleidomastoid muscle. The right side is more often afflicted than the left. A bilateral sternocleidomastoid pseudotumor of infancy is extremely rare. Biopsies (which typically should not be necessary) show spindle-like fibroblasts next to atrophic muscle cells and a low-grade inflammatory response can also be seen.  

     
     Pediatric Radiology CasesRadiological findings:


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: In the panorama-view (transversal neck soft tissue at the level of the thyroid isthmus), one sees an obvious thickening and structural changes of the right sternocleidomastoid muscle in comparison to the opposite side.


    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Longitudinal: The sternocleidomastoid muscle in comparison. Right - obvious spindle-like thickening of the sternocleidomastoid muscle with inhomogenic structure and some echogenic areas.



    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Sternocleidomastoid muscle transverse: comparison.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Transverse section of the right sternocleidomastoid muscle .



    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: In the color doppler examination, the inhomogenic perfusion within the thickened muscle is seen.



    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up ultrasound one month after the initial examination. Longitudinal images. The thickened right sternocleidomastoid muscle has regressed.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Total constellation (Consens)  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Solid mass, i.e. Rhabdomyosarcoma
    Neuroblastoma
    Lymphadenitis colli
    infantile desmoid fibromatosis  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    This is a non-neoplastic cervical mass, which is seen for over the course of a few months. Spontaneous regression is expected. The incidence is, according to literature, about 0.4%. In about 20% of the patients, a torticollis develops. Treatment: symptomatic, physical therapy with careful exercises to stretch the neck musculature.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Carty, Helen, et. al.
    Imaging of Children
    Churchill Livingstone, 1994.

    2. Medline: Medline
    Crawford, Stephen C., et. al.
    Fibromatosis Colli of Infancy: CT and Sonographic Findings
    AJR 151:1183-1184, December 1988

    3. Medline: Medline
    Siegel, Mariln J.
    Pediatric Sonography
    Raven Press, New York, 1993

    4. Medline: Medline
    Sharma S, Mishra K, Khanna G.
    Fibromatosis colli in infants. A cytologic study of eight cases.
    Acta Cytol. 2003 May-Jun;47(3):359-62.

    5. Medline: Medline
    Kumar V, Prabhu BV, Chattopadhayay A, Nagendhar MY
    Bilateral sternocleidomastoid tumor of infancy
    Int J Pediatr Otorhinolaryngol. 2003 Jun;67(6):673-5  

     
     Pediatric Radiology CasesKeywords:

    sternocleidomastoid pseudotumor of infancy, fibromatosis colli, head-nick hematoma, vacuum extraction, forceps delivery, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Fritz Schneble. Fibromatosis colli - sternocleidomastoid pseudotumor of infancy. PedRad [serial online] vol 5, no. 6.
    URL: www.PedRad.info/?search=20050603161131  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Neck-Muscular system / Connective tissue / Skin
    or in the region: Neck
    or in the tissue/organ: Muscular system / Connective tissue / Skin
    or with the etiology: unknown
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Fibromatosis colli - sternocleidomastoid pseudotumor of infancy
    Fritz Schneble. Fibromatosis colli - sternocleidomastoid pseudotumor of infancy. PedRad [serial online] vol 5, no. 6.
    URL: www.PedRad.info/?search=20050603161131


     

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    Fibromatosis colli - sternocleidomastoid pseudotumor of infancy
    Other cases by these authors:

    Search Fritz Schneble in Medline Fritz Schneble (7)   

    Fibromatosis colli - sternocleidomastoid pseudotumor of infancy  
     
    Fibromatosis colli - sternocleidomastoid pseudotumor of infancy
    Fritz Schneble. Fibromatosis colli - sternocleidomastoid pseudotumor of infancy. PedRad [serial online] vol 5, no. 6.
    URL: www.PedRad.info/?search=20050603161131


     

    Which diagnosis have other collegues guessed?


    • Rhabdomyosarcoma
      Votes: 3 (27 %)


    • Neuroblastoma
      Votes: 0 (0 %)


    • Lymphadenitis colli
      Votes: 0 (0 %)


    • Fibromatosis colli
      Votes: 8 (72 %)


    • ectopic Thymic Tissue
      Votes: 0 (0 %)



        Total answers: 11

     
    Fibromatosis colli - sternocleidomastoid pseudotumor of infancy
    Fritz Schneble. Fibromatosis colli - sternocleidomastoid pseudotumor of infancy. PedRad [serial online] vol 5, no. 6.
    URL: www.PedRad.info/?search=20050603161131


     

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    Fibromatosis colli - sternocleidomastoid pseudotumor of infancy
    Fritz Schneble. Fibromatosis colli - sternocleidomastoid pseudotumor of infancy. PedRad [serial online] vol 5, no. 6.
    URL: www.PedRad.info/?search=20050603161131


     




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