Q: My 75 years old father had an open heart surgery two years ago. A few weeks after the surgery, he developed a hard lump on the right side of his neck along with swelling. He was treated for an infection. The lump eventually subsided, but there was always a pea sized bump left. The lump/swelling has re-appeared numerous times over the past two years. It is always painful if he touches it or moves his neck. He has had numerous scans and they had not been able to determine the cause of this lump. The latest scan determined that there is a two inch mass located just behind the jugular. He is going in for a biopsy of the bump tomorrow. The area where the lump occurs is the same area in which he had a drainage type tube placed after his surgery. Is it possible that his jugular or something else was nicked during this process and it is periodically leaking? Is biopsy essential?

A:The most likely explanation is that he has recurrent infection at the site. I suspect that there is a stitch or other foreign body there. It is unlikely to be related to an artery or vein (like jugular vein), since your father has no bleeding, and has pain (which suggests infection). He should benefit from a small surgical procedure to check for a source of infection. Recommend to your doctors that the procedure should be done under general anesthesia rather than local. This will give them better control if they find something unexpected.