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Bilateral sternocleidomastoid tumors of infancy
R P Tufano1, L W Tom, M B Austin
1Division of Otolaryngology, Children's Hospital of Philadelphia, Wood Center, PA 19104, USA.
Insights
Sternocleidomastoid tumor of infancy (STOI) is a rare neck mass in infants. This case highlights bilateral STOIs, emphasizing the need for advanced imaging like MRI when clinical presentation is uncertain.
Area of Science:
- Pediatric Medicine
- Neonatology
- Musculoskeletal Imaging
Background:
- Sternocleidomastoid tumor of infancy (STOI) is an uncommon cause of neck masses in newborns.
- It typically presents as a unilateral mass in the sternocleidomastoid muscle (SCM) of infants aged 1-8 weeks, often associated with torticollis.
- Clinical diagnosis is common, but atypical presentations can pose challenges.
Observation:
- A case report of a 2-week-old female infant with bilateral STOIs and torticollis is presented.
- The bilateral nature of the masses introduced diagnostic uncertainty despite suggestive clinical features.
- Magnetic resonance imaging (MRI) was crucial for confirming the diagnosis.
Findings:
- Bilateral STOIs, while rare, can occur and mimic other conditions.
- MRI provides essential detail for diagnosing STOI, especially in atypical or bilateral cases.
- Early recognition and appropriate imaging are key for effective management.
Implications:
- This case underscores the importance of considering STOI in infants with lateral neck masses, even with unusual bilateral presentations.
- It highlights the utility of MRI in confirming STOI diagnoses when clinical suspicion is high but certainty is lacking.
- Understanding the spectrum of STOI presentation aids in timely and accurate diagnosis and management of this pediatric condition.
Abstract:
The sternocleidomastoid tumor of infancy (STOI) is a relatively uncommon condition. Typically, it presents as a firm, well circumscribed mass within the sternocleidomastoid muscle (SCM) in infants 1-8 weeks of age and may be associated with torticollis. This condition must be considered in any infant with a lateral neck mass. The diagnosis can often be made clinically, but unusual presentations may present diagnostic challenges. Although bilateral involvement is rare, it does occur. The second reported case, a 2-week old female with bilateral STOIs and torticollis, is reported. Although many of the characteristics of the masses suggested the condition, the bilateral nature added uncertainty to the clinical impression, and magnetic resonance imaging (MRI) was used to confirm the diagnosis. The clinical presentation and management of the STOI are reviewed, and the unusual features of this case are discussed.
