Pyogranulomatous mass in neck

RE: Pyogranulomatous mass in neck

Alasdair Hotston Moore — Sat, 29 Aug 2020 00:05:02 GMT

Sorry for the delay in my reply. I’d guess it’s actinomycosis. Can be hard to confirm but plan for at least six weeks treatment. Best wishes from Shanghai

RE: Pyogranulomatous mass in neck

Gillian Mostyn — Fri, 28 Aug 2020 15:18:38 GMT

Thank-you for your answer. Unfortunately it wouldn't have been possible (for me) to resect it - although it felt like a mass, there wasn't any one distinct 'lump' but instead just a large area of abnormal tissue, but extending from the skin on the left hand side all the way underneath the trachea towards the thoracic inlet. Removing it would have risked me damaging a lot of vital structures - I'm not a talented enough surgeon!

The op was done 5 days ago and although there is certainly still lumpy areas in the neck, the dog is doing fine. The owner is fully aware that more surgery may be needed.

RE: Pyogranulomatous mass in neck

Alasdair Hotston Moore — Fri, 28 Aug 2020 14:39:14 GMT

You have two choices. Explore the mass and hope to find a FB but leaving the mass behind if not (or making a mess and spreading infection first if you then try to remove it) or to plan to remove the mass. I’d go for the latter personally in your situation: attempt a clean excision. Bold approach, careful dissection. A suction drain would be a good plan. Send tissue for histo and culture because if there’s no FB it could be actinomycosis