Laryngeal lipomas are rare and generally present as progressive dyspnea or hoarseness.1,2 We discuss a case of a large laryngeal lipoma with unusual presentation causing delayed diagnosis. 

The patient initially presented with respiratory failure following narcotic administration for an unrelated condition, which ultimately led to tracheotomy after repeatedly failed extubation. 

Following decannulation, the patient experienced hoarseness and a progressive neck mass. Imaging demonstrated a large, submucosal mass with dimensions of 5.5x4.2x4.6 cm that was successfully excised with trans-cervical excision.

Medical record review indicates the patient’s lipoma was most likely present at the time of respiratory failure. Delayed diagnosis allowed for continual growth requiring invasive excision, which emphasizes the need to maintain a broad differential for respiratory failure, including obstructive masses.

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