Unusual case of cervical swelling

Fibromatosis Colli is an uncommon benign cervical pseudotumor in neonates and infants with a prevalence estimated at 0.4%.¹ This condition involves the proliferation of benign fibrous tissue within the SCM, leading to a spindle-shaped enlargement.² It typically presents within the first 8 weeks of life, most frequently in males and it is located on the right side in 73% of cases. The etiology of fibrosis remains elusive; however, potential associations include trauma during pregnancy or at birth, resulting in haemorrhage and subsequent fibrosis.^1,2,3 Ultrasound serves as a crucial diagnostic tool for confirmation and follow-up.^3,4 This lesion can be distinguished from other neck masses, like rhabdomyosarcoma and neuroblastoma, by its well-defined margins, absence of extension beyond the sternocleidomastoid muscle, normal surrounding fascial planes and no vascular encasement or associated cervical adenopathy.² Unlike cystic hygroma and abscess, it lacks fluid content. The tumor has a natural tendency to resolve on its own within 4-8 months of its onset.³ Conservative approaches such as physical therapy and massage effectively manage the condition, with surgery being seldom necessary and reserved for persistent tumors.²

References :

Kumar V, Prabhu BV, Chattopadhayay A, Nagendhar MY. Bilateral sternocleidomastoid tumor of infancy. Int J Pediatr Otorhinolaryngol 2003 Jun 67 (6):673-5. DOI: https://doi.org/10.1016/S0165-5876(03)00070-3 Baik G, Blask A, Reilly BK. Unilateral Neck Mass in a Neonate. The Journal of Pediatrics. 2018 Nov 202:329. DOI: https://doi.org10.1016/j.jpeds.2018.05.005 Narsi S, Afilal I, Missaoui Z, El Aggari H, Kamaoui I, Aichouni N et al. Fibromatosis Colli: A case report. Radiology Case Reports. 2022 Mar 17 (3):693-695.DOI: https://doi.org/10.1016/j.radcr.2021.12.009 Lengane NI, Some MJM, Tall M, Ouermi AS, Nikiema JP, Ouoba JW et al. Le fibromatosis colli: une tumeur cervicale rare du nourrisson. PanAfrican Medical Journal. 2020 dec 37(370).DOI: 10.11604/pamj.2020.37.370.24635