[An infant with sternal swelling]

Abstract

Background: Sternal tumours in childhood are rare and alarming. These can be differentiated into benign and malignant tumours. This differentiation is important for the prevention of unnecessary diagnostic testing.

Case report: An 11-month-old girl was seen at the Emergency Department for an acute sternal swelling without obvious trauma or fever. There were no other symptoms or abnormalities found on physical examination. An ultrasound revealed a typical 'dumb bell' sign. This finding, in combination with the clinical picture, indicated a 'self-limiting sternal tumour of childhood' (SELSTOC). Because of this diagnosis, the continuation of further examinations and treatment was abandoned and an expectative course was followed. The swelling completely disappeared within a few weeks.

Conclusion: SELSTOC is a benign swelling on the sternum occurring in childhood, probably caused by aseptic inflammation. Its acute presentation is alarming and leads to over-diagnosing. However, the combination of the typical clinical presentation and the characteristic ultrasonographic dumb-bell sign justifies an expectative course. The abnormality resolves spontaneously within 6 months.