She is having a recurrence at local site - we have to confirm that with a biopsy from local site , that is the first step . Further treatment - if disease is confirmed surgical option is the best , but operability of a lesion this higher is a not very good . Surgery followed by post operative radiation. If this patient was not irradiated after last surgery , radiotherapy with chemotherapy is an option for treatment , if surgeon says surgery is difficult . The lesion in lung seems to be infective. May need treatment with medication .