Presentation
Uncomplicated vacuum assisted vaginal delivery, presented with a painless lump in the right cervical area. No fever or apathy. Normal breastfeeding pattern. On physical examination, mild torticollis to the left side, firm lump over the right neck area without any skin redness. Blood exams showed normal blood count and CRP levels.
Patient Data
The right sternocleidomastoid muscle demonstrates fusiform enlargement accompanied by disruption of the normal striated appearance of the muscle. Mild hyperemia is seen within the muscle, without evidence of focal mass lesion. The left sternocleidomastoid muscle shows a normal sonographic appearance.
Case Discussion
This case represents a benign infantile sternocleidomastoid muscle fibromatosis. The patient's history of vacuum assisted vaginal delivery is a known risk factor.
The proposed mechanism for fibromatosis colli is birth trauma leading to intramuscular hemorrhage, and subsequent fibrosis.
Ultrasound is the imaging modality of choice and performed for diagnostic confirmation as well as the exclusion of other pathology in the neck.
Courtesy of Dr. Maxim Pougatchev.