Hi, Would be grateful if you could explain the CT scan report of my son, 12, who had a lump in his left side of his neck. The scan was done on 3 Jan 09. He had the lump in mid Nov 08. He experiences no pain or any discomfort but we are very worried.

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EXAMINATION: CT SCAN NECK SKULL BASE TO THE THORACIC INLET
Helical scans were done with I/V contrast from base of skull to thoracic inlet. Reconstruction was done in coronal and axial planes.

FINDINGS:
Sections through the nasapharynx revealed fairly symmetrical fossa of Rossenmuller. The sinunes are clear. There is a enhancing mass lesion noted in the left post styloid parapharyngeal space or carotid space. The mass lesion measures about 54.4 x 33.5 x 41.3 mm. It extends from the 2nd cervical vertebrae to the 4th cervical vertebrae. The mass lesion is posterior to the left mandible and it is lateral to the left carotid artery. The carotid artery appears normal. The left jugular vein is compressed and displaced posteriorly. The mass lesion is enhancing inhomogeneously. There are areas of low attenuation noted within the mass lesion suggstive of areas of necrosis or cystic degeneration. The mass lesion is medial to the left sternomastoid muscle. There are also mutiple small enhancing nodules noted adjacent to it superiorly and inferiorly along the cervical chain suggestive of lymph nodes. It measures about 1 cm or less.

IMPRESSION:
The left enhancing mass lesion in the left carotid space is probably enlarged internal jugular nodes of the deep cervical chain. The other possibility is this area are the paragangiomas. Need to correlate with clinical picture.

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Question 1: where exactly is the lump? in the lymph nodes or just a lump outside the lymph nodes?

Question 2: is this an inflammation or a growth?

Question 3: what should I do next?

Doc can't explain the above report, he only suggested surgical removal. Please help.