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The presentation and management of fibromatosis colli
Kristen C Lowry1, Judy A Estroff, Reza Rahbar
1Department of Otolaryngology and Communication Enhancement, Children's Hospital, Boston, MA 02115, USA.
Insights
Fibromatosis colli, a common infant neck mass, often presents with torticollis. Early physiotherapy and observation lead to excellent outcomes, preventing long-term craniofacial asymmetry.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Musculoskeletal Disorders
Background:
- Fibromatosis colli is a benign fibrous tumor affecting sternocleidomastoid muscles in infants.
- It commonly presents as a neck mass and can lead to torticollis and craniofacial asymmetry.
Purpose of the Study:
- To review cases of fibromatosis colli at Children's Hospital in Boston.
- To evaluate the effectiveness of conservative management, specifically physiotherapy, for fibromatosis colli.
Main Methods:
- Systematic chart review of infants diagnosed with fibromatosis colli between January 1999 and December 2004.
- Data collected included birth history, clinical presentation, medical history, imaging, management, and outcomes.
Main Results:
- Seven cases (4 boys, 3 girls) aged 1-3.5 weeks were identified.
- Six presented with a neck mass; five developed torticollis.
- All patients received conservative management with physiotherapy, resulting in complete resolution (5/7) or improvement (2/7).
Conclusions:
- Early identification and conservative management, including physiotherapy, are crucial for treating fibromatosis colli.
- Physiotherapy helps prevent or reverse torticollis and associated craniofacial asymmetry.
- This approach optimizes outcomes and minimizes unnecessary healthcare costs.
Abstract:
We conducted a systematic chart review to identify all infants with fibromatosis colli who had been seen at Children's Hospital in Boston from January 1999 through December 2004. We found 7 such cases, which involved 4 boys and 3 girls, aged 1 to 3.5 weeks at presentation. We compiled information on each patient's birth history, presenting signs and symptoms, significant medical history, imaging findings, management, follow-up, and outcome. Six of the 7 patients presented with a neck mass, and the remaining patient presented with neck "fullness." Five patients developed torticollis at some point. All patients were treated conservatively with physiotherapy. Five patients experienced a complete resolution of signs and symptoms, and the other 2 experienced improvement. Based on our findings, we recommend that early management of fibromatosis colli include observation and physiotherapy to prevent or reverse torticollis and the craniofacial asymmetry that can result. Similarly attractive is the opportunity that physiotherapy provides for parents to involve themselves in the care of their newborn. It is important, therefore, to quickly identify fibromatosis colli as such in order to avoid unnecessary expenditures of resources and to promptly begin conservative treatment.
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