Fibromatosis colli

Fibromatosis colli is a rare, benign condition characterized by the proliferation of fibrous tissue within the sternocleidomastoid muscle of the neck, leading to a firm, non-tender mass. It is most commonly diagnosed in infants, typically within the first few weeks of life, and is considered a form of congenital muscular torticollis. The exact cause of fibromatosis colli remains unclear, but it is thought to be related to birth trauma or intrauterine malposition.

Etiology

The etiology of fibromatosis colli is not fully understood, but several theories have been proposed. One theory suggests that the condition may result from trauma to the neck muscle during birth, leading to hemorrhage, fibrosis, and subsequent shortening of the muscle. Another theory posits that intrauterine malposition can cause decreased blood flow to the sternocleidomastoid muscle, resulting in fibrosis.

Symptoms

The primary symptom of fibromatosis colli is a palpable, firm mass in the sternocleidomastoid muscle, which can cause the head to tilt towards the affected side with the chin pointing towards the opposite side, a condition known as torticollis. The mass is typically non-tender and may be discovered within the first two months of life. In some cases, a limited range of motion in the neck may also be observed.

Diagnosis

Diagnosis of fibromatosis colli is primarily clinical, based on physical examination findings. Ultrasound imaging can be used to confirm the diagnosis, showing a characteristic enlargement and increased echogenicity of the affected sternocleidomastoid muscle. In some cases, magnetic resonance imaging (MRI) may be utilized to rule out other causes of neck masses in infants.

Treatment

The treatment of fibromatosis colli primarily involves physical therapy aimed at stretching the affected muscle and improving neck mobility. Early intervention is crucial for optimal outcomes. In most cases, physical therapy exercises can be performed by parents under the guidance of a physical therapist. In more severe cases, or if conservative treatment fails, surgical intervention may be considered to release the muscle.

Prognosis

The prognosis for infants with fibromatosis colli is generally good, especially with early diagnosis and treatment. Most infants respond well to physical therapy, with significant improvement or complete resolution of the mass and correction of the torticollis. However, early intervention is key to preventing permanent shortening of the muscle and avoiding complications such as facial asymmetry and plagiocephaly.

Prevention

Since the exact cause of fibromatosis colli is not known, specific preventive measures are difficult to establish. However, avoiding known risk factors, such as birth trauma, may potentially reduce the risk of developing the condition.