FIBROMATOSIS COLLI(FC)–PSEUDOTUMOR OF INFANCY(POI)—COLLUM DISTORTUM—CONG. TORTICOLLIS—FIBROUS HEMATOMA OF THE SCM—-SCM FIBROMA OF NEONATES—SCM TUMOR
DO NOT CONFUSE WITH MUSCULAR TORTICOLLIS (TIGHTENING OF THE MUSCLE WITHOUT A MASS) OR BENIGN PAROXYSMAL VERTIGO OF CHILDHOOD WITH TORTICOLLIS
15% WITHOUT TREATMENT CAN GO ON TO DEVELOP MUSCULAR TORTICOLLIS AND SUBSEQUENT FACIAL ASYMMETRY
MUSCULAR TORTICOLLIS (WRY NECK) IS A DISTINCT ENTITY WHICH PEAKS AT AGE 3-4—ONLY 25-30% OF PTS WITH CONG MUSCULAR TORTICOLLIS HAVE Hx OF FC
0.4% OF ALL BIRTHS
MALE=FEMALE
MOST COMMON LAT NECK MASS IN NEONATES
80-90% RESOLUTION BY 6 MONTHS
ETIOLOGY–PROBABLY INTRAUTERINE POSITIONING—INTRAMUSCULAR VENOUS OCCLUSION—FIBROSIS—CONTRACTURE
OFTEN COINCIDES WITH BREECH OF FORCEPS DELIVERY
PRESENTS AS OVOID/FUSIFORM HARD PAINLESS MASS AT THE JUNCTION OF THE MIDDLE AND UPPER THIRD
PTS HEAD IS USUALLY TURNED AWAY FROM THE MASS
IN AN OTHERWISE HEALTHY INFANT
USUALLY PRESENTS IN 1ST 10 DAYS OF LIFE
PROGRESSES TO MAXIMAL SIZE AT ONE MONTH
CAN DIAGNOSE WITH ULTRASOUND—DO NOT NEED A Bx?
FACIAL ASYMMETRY(MILD IPSILATERAL HEMIFACIAL MICROSOMIA/PLAGIOCEPHALY/FACIAL HEMIHYPOPLASIA,OCCIPITAL FLATTENING) MAY BE PART OF THE SYNDROME OF AN AVOIDABLE SEQUELLA
SCOLIOSIS MAY ALSO FOLLOW
Dx: Hx, PE, US, CT, MRI
RECENT ARTICLE ADVOCATES FNA—BENIGN SPINDLE CELL LESION
Rx: PT—PASSIVE CERVICAL STRETCHING BY PARENTS—CHIN TO SHOULDERS 6 X PER DAY—-HEAT
OCCASIONALLY REQUIRE SURGERY–DISTAL SCM RELEASE-BOTOX