A 14-year old male patient was referred to our outpatient dermatology service by his pediatric Nurse Practitioner (NP) for a firm, flesh-colored nodule on the left side of his anterior neck. (Figure 1) It had been present since birth and was not growing in size. He denied pain, tenderness, itch, and purulence-however, the mass rubbed daily on his shirt collar, and peers at school teased him about it, causing anxiety. The patient and his mother requested that the mass be removed. Eighteen months prior to presentation at dermatology, his pediatric NP ordered a soft tissue neck computed tomography (CT) with contrast, which revealed "a focal, nonspecific skin thickening in the left supraclavicular neck, with a prominent vein at this location. No worrisome underlying mass [was] identified." The patient's medical history included anxiety, attention deficit hyperactivity disorder (ADHD), mild depression, and enlarged vestibular aqueducts.