Fibromatosis colli also known as sternocleidomastoid tumor of infancy, congenital muscular torticollis, is a medical condition that affects the neck muscles in infants. Also known as the sternocleidomastoid tumor of infancy, it is a benign growth that occurs in the sternocleidomastoid muscle, which runs from the back of the ear to the collarbone. Fibromatosis colli is a relatively common condition, affecting approximately 0.4% to 2% of all newborns. In this article, we will discuss the definition, types, symptoms, causes, diagnosis, and treatment of fibromatosis colli in detail.
Fibromatosis colli is a benign mass or tumor that develops in the sternocleidomastoid muscle of the neck in infants. It is a self-limiting condition that usually resolves spontaneously within a few months. Fibromatosis colli is characterized by a palpable, firm, and painless mass that is located in the neck, typically on one side. The mass can cause the baby’s head to tilt to the affected side and limit the baby’s neck’s range of motion. The condition is also known as congenital muscular torticollis.
Types
It is also known as sternocleidomastoid tumor of infancy (SCM), congenital muscular torticollis, or pseudotumor of infancy. In this article, we will discuss the different types of fibromatosis colli.
- Congenital Fibromatosis Colli
Congenital fibromatosis colli is the most common type of SCM. It occurs in infants at birth or within the first few months of life. The cause of congenital fibromatosis colli is unknown, but it is thought to be due to the stretching or tearing of the sternocleidomastoid muscle during delivery.
- Acquired Fibromatosis Colli
Acquired fibromatosis colli is less common than congenital fibromatosis colli. It usually occurs in older infants and young children. The cause of acquired fibromatosis colli is also unknown, but it may be due to an injury to the neck or a reaction to a vaccine.
- Sternocleidomastoid Tumor of Infancy
Sternocleidomastoid tumor of infancy is another name for congenital fibromatosis colli. It is called a “tumor” because it is a mass or lump, but it is not cancerous. This type of fibromatosis colli usually goes away on its own within a few months.
- Congenital Muscular Torticollis
Congenital muscular torticollis is another name for fibromatosis colli. It is a condition in which the sternocleidomastoid muscle is shortened or contracted, causing the head to tilt to one side. This can lead to a flattening of the head on one side.
- Pseudotumor of Infancy
Pseudotumor of infancy is another name for fibromatosis colli. It is called a “pseudotumor” because it is a mass or lump, but it is not a true tumor or cancerous. This type of fibromatosis colli usually goes away on its own within a few months.
Causes
While the exact cause of fibromatosis colli is unknown, there are several factors that have been associated with the development of the condition and potential causes of fibromatosis colli.
- Birth trauma: Trauma during the birthing process, such as forceps delivery, may increase the risk of fibromatosis colli.
- Fetal malposition: Abnormal fetal position, such as a breech presentation, may also increase the risk of fibromatosis colli.
- Maternal health: Maternal health conditions, such as gestational diabetes or preeclampsia, may increase the risk of fibromatosis colli.
- Genetic factors: Genetic factors may play a role in the development of fibromatosis colli, as the condition tends to run in families.
- Hormonal factors: Hormonal imbalances may contribute to the development of fibromatosis colli, as the condition is more common in females.
- Environmental factors: Exposure to certain environmental toxins or pollutants may increase the risk of fibromatosis colli.
- Infections: Certain viral infections, such as Epstein-Barr virus, may increase the risk of fibromatosis colli.
- Inflammation: Inflammation may contribute to the development of fibromatosis colli.
- Immune system disorders: Immune system disorders, such as lupus or rheumatoid arthritis, may increase the risk of fibromatosis colli.
- Medications: Certain medications, such as hormonal contraceptives, may increase the risk of fibromatosis colli.
- Trauma: Trauma to the neck or head may increase the risk of fibromatosis colli.
- Muscle strain: Repetitive strain on the sternocleidomastoid muscle may increase the risk of fibromatosis colli.
- Congenital abnormalities: Congenital abnormalities, such as torticollis, may increase the risk of fibromatosis colli.
- Low birth weight: Low birth weight may increase the risk of fibromatosis colli.
- Premature birth: Premature birth may increase the risk of fibromatosis colli.
- Prenatal exposure to tobacco: Prenatal exposure to tobacco smoke may increase the risk of fibromatosis colli.
- Prenatal exposure to alcohol: Prenatal exposure to alcohol may increase the risk of fibromatosis colli.
- Prenatal exposure to drugs: Prenatal exposure to certain drugs, such as antiepileptic medications, may increase the risk of fibromatosis colli.
- Maternal age: Maternal age may play a role in the development of fibromatosis colli, as the condition is more common in older mothers.
- Gestational age: The gestational age of the infant may play a role in the development of fibromatosis colli.
While these factors have been associated with the development of fibromatosis colli, it is important to note that the exact cause of the condition is still unknown. If you suspect that your child may have fibromatosis colli, it is important to speak with your pediatrician for an accurate diagnosis and treatment plan.
Symptoms
The tumor arises from the sternocleidomastoid muscle, which is a muscle located on either side of the neck that is responsible for turning the head.
The following are the symptoms that are commonly associated with fibromatosis colli:
- Presence of a lump or swelling in the neck region
- Restricted movement of the head and neck
- Tilted head position
- Asymmetry of the neck
- Pain or discomfort in the neck
- Stiffness in the neck muscles
- Headaches
- Fatigue
- Irritability or fussiness
- Difficulty sleeping
- Difficulty feeding or swallowing
- Failure to thrive or weight loss
- Excessive crying or colic-like symptoms
- Skin discoloration or redness over the affected area
- Skin dimpling or puckering over the affected area
- Palpable mass that is mobile and non-tender
- Muscle atrophy or wasting of the affected muscle
- Scalp changes or hair loss over the affected area
- Torticollis or wry neck
- Abnormal head posture or head tilt
Diagnosis
It is the most common benign tumor in infants and occurs in approximately 0.4% to 2% of newborns and diagnoses and tests for fibromatosis colli.
- Physical examination: The first step in diagnosing fibromatosis colli is a physical examination. The doctor will examine the neck and look for any swelling or masses.
- Ultrasound: Ultrasound is a non-invasive test that uses sound waves to produce images of the body. It is commonly used to diagnose fibromatosis colli.
- Magnetic resonance imaging (MRI): MRI is a non-invasive test that uses a powerful magnet and radio waves to produce detailed images of the body. It is useful for diagnosing fibromatosis colli and determining the extent of the tumor.
- Biopsy: A biopsy is a procedure in which a small sample of tissue is removed from the tumor and examined under a microscope. It is used to confirm the diagnosis of fibromatosis colli.
- Blood tests: Blood tests are not used to diagnose fibromatosis colli, but they may be used to rule out other conditions.
- X-ray: X-ray is not a common test for fibromatosis colli, but it may be used to rule out other conditions.
- Computed tomography (CT) scan: CT scan is a non-invasive test that uses x-rays to produce detailed images of the body. It is used to diagnose fibromatosis colli and determine the extent of the tumor.
- Fine needle aspiration (FNA): FNA is a procedure in which a thin needle is inserted into the tumor and a small sample of cells is removed for examination under a microscope. It is used to confirm the diagnosis of fibromatosis colli.
- Genetic testing: Genetic testing is not commonly used to diagnose fibromatosis colli, but it may be used to rule out other conditions.
- Immunohistochemistry (IHC): IHC is a technique used to identify specific proteins in the tumor tissue. It is used to help diagnose fibromatosis colli.
- Positron emission tomography (PET) scan: PET scan is a non-invasive test that uses a small amount of radioactive material to produce detailed images of the body. It is used to diagnose fibromatosis colli and determine the extent of the tumor.
- Electroencephalogram (EEG): EEG is a test that records the electrical activity of the brain. It is not used to diagnose fibromatosis colli, but it may be used to rule out other conditions.
- Electromyogram (EMG): EMG is a test that records the electrical activity of the muscles. It is not used to diagnose fibromatosis colli, but it may be used to rule out other conditions.
- Arteriography: Arteriography is a test that uses contrast material and X-rays to visualize the arteries. It is not commonly used to diagnose fibromatosis colli, but it may be used to rule out other conditions.
- Thyroid function tests: Thyroid function tests are not used to diagnose fibromatosis colli, but they may be used to rule out other conditions.
- Chest X-ray: Chest X-ray is not commonly used to diagnose fibromatosis colli, but it may be used to rule out other conditions.
Treatment
It is characterized by a mass or swelling in the muscle of the neck, known as the sternocleidomastoid muscle. This can cause the child’s head to tilt to one side and may lead to difficulty moving the head and neck. Here are potential treatments for fibromatosis colli:
- Physical therapy: Physical therapy is a common treatment for fibromatosis colli. It can help to improve range of motion in the neck and reduce the severity of symptoms.
- Stretching exercises: Stretching exercises can be done at home or with the help of a physical therapist. These exercises can help to stretch and strengthen the muscles in the neck.
- Massage therapy: Massage therapy can help to relieve muscle tension and reduce pain associated with fibromatosis colli.
- Heat therapy: Applying heat to the affected area can help to relax the muscles and reduce pain.
- Cold therapy: Applying cold to the affected area can help to reduce swelling and inflammation.
- Ultrasound therapy: Ultrasound therapy uses sound waves to promote healing and reduce pain.
- Electrical stimulation therapy: Electrical stimulation therapy can help to improve muscle function and reduce pain.
- Acupuncture: Acupuncture can help to reduce pain and promote healing in the affected area.
- Chiropractic care: Chiropractic care can help to improve spinal alignment and reduce tension in the neck muscles.
- Medications: Over-the-counter pain relievers, such as acetaminophen and ibuprofen, can help to reduce pain associated with fibromatosis colli.
- Muscle relaxants: Muscle relaxants can help to reduce muscle tension and improve range of motion in the neck.
- Corticosteroid injections: Corticosteroid injections can help to reduce inflammation and pain in the affected area.
- Surgery: In severe cases, surgery may be necessary to remove the affected muscle.
- Taping: Taping the affected area can help to improve posture and reduce tension in the neck muscles.
- Craniosacral therapy: Craniosacral therapy is a gentle hands-on therapy that can help to release tension in the neck muscles.
- Osteopathic manipulation: Osteopathic manipulation can help to improve spinal alignment and reduce tension in the neck muscles.
- Myofascial release: Myofascial release is a form of massage therapy that can help to release tension in the muscles and fascia of the neck.
- Trigger point therapy: Trigger point therapy can help to release tight knots in the muscles and improve range of motion in the neck.
- Hydrotherapy: Hydrotherapy involves the use of water to promote healing and reduce pain.
- Mind-body therapies: Mind-body therapies, such as meditation and yoga, can help to reduce stress and tension in the neck muscles.
Medications
Fortunately, there are several drug treatments available for fibromatosis colli that can help manage the symptoms and reduce the size of the growth. Here are some of the most commonly prescribed drugs for treating this condition:
- Corticosteroids: These drugs are often the first line of treatment for fibromatosis colli. Corticosteroids work by reducing inflammation in the affected muscle, which can help relieve pain and stiffness. They can also slow down the growth of the fibromatosis colli, and in some cases, even shrink the tumor. Corticosteroids are usually administered through injections directly into the affected muscle.
- Beta-blockers: Beta-blockers are a class of drugs that are commonly used to treat high blood pressure and heart conditions. However, they can also be effective in treating fibromatosis colli. Beta-blockers work by blocking the effects of adrenaline in the body, which can reduce the blood flow to the affected muscle and slow down the growth of the fibromatosis colli.
- Interferon: Interferon is a type of protein that is naturally produced by the body in response to viral infections and other types of inflammation. It has been found to be effective in treating fibromatosis colli by slowing down the growth of the tumor and reducing inflammation. Interferon is usually administered through injections directly into the affected muscle.
- Methotrexate: Methotrexate is a chemotherapy drug that is sometimes used to treat fibromatosis colli. It works by stopping the growth of cells, including the cells that make up the fibromatosis colli. Methotrexate is typically administered through injections or oral tablets.
- Tamoxifen: Tamoxifen is a drug that is commonly used to treat breast cancer. However, it has also been found to be effective in treating fibromatosis colli. Tamoxifen works by blocking the effects of estrogen in the body, which can slow down the growth of the fibromatosis colli. It is usually administered through oral tablets.
- Sirolimus: Sirolimus is an immunosuppressant drug that is sometimes used to treat fibromatosis colli. It works by blocking a specific protein in the body that is involved in cell growth and division. Sirolimus can help slow down the growth of the fibromatosis colli and reduce inflammation. It is typically administered through oral tablets.
