Neoplasms of the trachea are uncommon, accounting for only 0.2% of all respiratory malignancies in the United States. 1 The incidence of primary tracheal cancer is estimated to be 1 in every 1,000,000 persons per year. Cancers of the bronchi occur approximately 400 times more frequently than tracheal cancer. The majority, 90%, of tracheal tumors in adults are malignant with squamous cell carcinoma (SCC) and adenoid cystic carcinoma (ACC) being the most common. Most of the airway tumors in children are benign. 2,3 Given the rarity of these neoplasms and their nonspecific clinical presentations, the diagnosis is often delayed by months or even years. Increased awareness and detection of airway neoplasms by radiologists is, therefore, of paramount importance in the care of these patients.