Proposal for Early Diagnosis of Congenital Muscular Torticollis: Case-based Approach: Report of two cases

Congenital muscular torticollis (CMT) is called 'pseudotumor of infancy' because it is commonly discovered and diagnosed within 14~28 days after birth as a sternomastoid tumor. We report two cases of CMT which presented as head tilt without any palpable neck mass immediately after birth but later developed into sternomastoid tumors. Serial ultrasonography confirmed increased echogenicities of the sternocleidomastoid muscles. We think that these findings are prodromal signs of sternomastoid tumors. Close physical examination by a neonatologist is crucial for an early diagnosis of CMT. Neonates with head tilt and increased ecogenicity of the sternocleidomastoid muscle on ultrasonography should be carefully followed up to see whether neck mass develops later. The authors suggest that CMT is not a static entity but rather one that progress to mass alteration after birth.

Two Cases of Sternomastoid Tumor / 대한이비인후과학회지

Sternomastoid tumor has long been recognized as a peculiar fibrous growth of the sternocleidomastoid muscle that usually appears during first several weeks of life. Sternomastoid tumor has often been referred to as "congenital torticollis" or "congenital muscular torticollis" because it is often associated with muscular torticollis. Some authors prefer to discuss them separately as either "sternomastoid tumor" when mass is palpable, or "muscular torticollis" when only tightness of sternomastoid muscle is present. Although it is disputed whether sternomastoid tumor will lead to muscular torticollis, 1/4-1/3 numbers of sternomastoid tumor does progress to muscular torticollis. However, muscular torticollis may occur in children without history of a mass in the sternocleidomastoid muscle. We present two cases of sternomastoid tumor that is combined with torticollis, one case was treated by physiotherapy and the other by surgery.