Presentation
Painless swelling of the left lateral aspect of the neck.
Patient Data
There is a hypoechoic soft tissue mass containing foci of calcification (phleboliths) within the left sternocleidomastoid muscle, highly vascularized on color doppler.
Asymmetrical size of the sternocleidomastoid muscles (SCM), the right is larger than the left with no fatty infiltration (may represents an anatomical variant). There is a small ovoid soft tissue mass within the left SCM, measuring (25x20x10 mm) at the level of C5 of intermediate signal intensity on T1WI (higher than that of the muscles), high signal intensity on T2WI, containing foci of low signal (phleboliths) with high signal on DWI and ADC. The postcontrast sequences show a progressive and heterogeneous enhancement.
Case Discussion
The MRI appearance is highly suggestive of an intramuscular hemangioma within the sternocleidomastoid muscle.
Additional contributor: A Ramdani, MD