Desmoid fibromatosis in the pharyngeal wall: A case report and literature review

Desmoid fibromatosis-a diagnostic dilemma

PURPOSE

Desmoid fibromatosis in head and neck is infrequent and poses a significant challenge to the clinicians due to its non-specific characteristics.

METHODS

This case report focuses on a 69-year-old male who presented to a tertiary healthcare center in Karnataka, India with a swelling in the oral cavity.

RESULTS

Despite initial suspicions of malignancy based on clinical examination and findings on computed tomography imaging, subsequent histopathology and immunohistochemistry revealed an unexpected finding.

CONCLUSION

The case highlights the importance of clinical suspicion and histopathological evaluation as well as the need for greater awareness to facilitate early diagnosis and appropriate management of desmoid fibromatosis. We also present a literature review of varied presentations of desmoid tumors afflicting various subsites of the head and neck.

Fibromatosis Colli: A Thorough Description of Its MRI Characteristics and a Review of the Literature

Introduction

Fibromatosis colli (FC) is a rare pseudotumor of the sternocleidomastoid muscle with an incidence of 0.4%, generally diagnosed using ultrasound between 2 and 4 weeks of age. This is an important entity considering the clinical concerns it causes due to its appearance as a cervical mass with torticollis. Few magnetic resonance imaging (MRI) descriptions of its appearance have been made, with the existing reported cases being sporadic. We aim to provide a thorough description of this paediatric entity.

Materials and Methods

We conducted a retrospective study by searching our hospital's database for previous cases of FC where an MRI had been performed. We found six cases of FC where an MRI had been performed. Of these cases, five out of six were contrast-enhanced. We examined the MRIs to be able to discern and describe the MRI characteristics of FC.

Results

We found that FC presents a T1 signal isointense to the muscle, a T2 signal hyperintense to the muscle, a variable diffusion signal and a thick enhancing peripheral ring after contrast administration.

Discussion

Our results match what has been reported in the literature to date regarding the MRI signal of FC, confirming previous reports. However, we provide new data regarding the characteristic appearance post-enhancement, which was previously unreported.

Conclusion

The MRI characteristics of FC have rarely been described, with only a few isolated case reports in the medical literature. We review the current literature, describe the key MRI characteristics of the pathology, and provide the most thorough description to date.