Abstract

Fibromatosis colli is a rare congenital pseudotumor of the sternocleidomastoid muscle, mainly found in the pediatric population. We propose to present four cases diagnosed in the ENT-Neck and head surgery department of the university medical center Mohammed VI in Marrakech, moreover we will recap the management strategy of this entity but also its evolution. We received in the pediatric emergency three infants of 1, 3 and 6 months old and one child of 7 years old, with as a main symptom a painful congenital torticollis. The ultrasound added to our clinical inspection allowed us fairly easily to diagnose the patients. No drug or surgical treatment was prescribed in the infant cases, though surgical treatment was inevitable in the 7 years old patient’s case. During the follow-up, carried out each month, we observed a gradual regression of swelling and torticollis. The prevalence of FC is estimated at 0.3-2% of births. The diagnosis is made at the age of 3 to 4 weeks of life by a thorough inspection of a torticollis associated with a later cervical mass in the framework of a difficult delivery (use of forceps or suction cup). Ultrasonography allows us to diagnose this entity due to the typical aspect of a fusiform thickening of the Sternocleidomastoid muscle. Surgical and medical treatment is rarely useful, and only symptomatic treatment is indicated. The spontaneous evolution of Fibromatosis colli is, even in the absence of treatment, the regression spontaneously in 4 to 6 months. Fibromatosis colli is a relatively rare entity, its frequency in Africa remains to be established, but it is clear that an early diagnosis is key to a speedy recovery.

Highlights

  • Fibromatosis colli is a rare congenital pseudotumor of the sternocleidomastoid muscle, found mainly in the pediatric population [1]

  • Its etiology is still unknown to this day, its main symptom remains a congenital torticollis and ultrasound is usually sufficient for diagnosis, in some cases MRI and CT are required

  • We propose to present 4 diagnosed cases in the ENT-Head and neck surgery department of Mohammed VI medical center of Marrakech, we will summarize the management of this entity and its evolution

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Summary

INTRODUCTION

Fibromatosis colli is a rare congenital pseudotumor of the sternocleidomastoid muscle, found mainly in the pediatric population [1]. Its etiology is still unknown to this day, its main symptom remains a congenital torticollis and ultrasound is usually sufficient for diagnosis, in some cases MRI and CT are required. The treatment of this relatively rare pathology is conservative and allows a spectacular evolution in 4 to 6 months. One case was surgically treated with partial Sternocleidomastoid muscle section and patient's neck immobilization and concomitant rehabilitation, it was the 7-year-old case, after we noted no improvement and an important functional handicap to the child (Fig. 3). The evolution over 6 months, in all cases including the surgical one, noted a disappearance of torticollis and laterocervical mass

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