A 21-month-old girl presented with a decreased range of neck movements for 6 months and an ill-defined, firm, 8 *4 cm swelling over her right trapezius and occipital region. She also had congenital valgus deformities of her great toes (fig 1).MRI revealed diffuse infiltration of the muscles of her neck extending from the occipital area to the superficial muscles of her posterior chest wall (fig 2). Expansion of the diploic space of the left parietal bone was also noted#
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