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An elderly gentleman with a chronic cough was found to have a large midtracheal lesion on computed tomography scan. Endotracheal extirpation with an electrocautery snare successfully removed the lesion. Histologic and immunohistochemical analyses revealed the lesion to be a spindle cell lipoma. We provide herein the case presentation and management, the differential diagnosis, and an overview of spindle cell lipoma.

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Aggressive angiomyxoma (AAM) is a rare, locally aggressive, slowly growing mesenchymal tumor found usually in the genital, perineal and pelvic regions of females, notorious for recurrences after surgical excision; it was first described by Steeper and Rosai [1] in 1983. The female-tomale ratio is 6 : 1. The age distribution is wide, with a peak incidence between ages 31 to 35. The reported local recurrence varies from 9 to 72% in the long-term follow-up [2]. AAM is often ignored until it grows to a large size. It is difficult to make a definitive diagnosis before operation.