Abstract
Tracheal lipomas, though exceedingly rare among benign tracheal masses, present unique diagnostic and management challenges due to their unusual clinical course. This case report documents the presentation and surgical management of a 56-year-old male with a tracheal lipoma, a first documented case in Puerto Rico. The patient presented with progressive dyspnea and stridor, initially misdiagnosed and treated as asthma exacerbations. Imaging confirmed a pedunculated tracheal mass, prompting emergency surgical intervention to secure the airway and excise the mass successfully. Histopathological analysis confirmed the mass as a benign tracheal lipoma. This case emphasizes the importance of considering rare tracheal tumors in the differential diagnosis of unexplained respiratory distress and advocates for tailored management strategies informed by comprehensive multidisciplinary approaches.