67-year-old woman with history of non-small cell lung cancer underwent right upper lobectomy 7 months prior to admission. She presented to ER with increasing shortness of breath and stridor. A 7.6 x 5.5 x 6.2 cm anterior mediastinal mass was identified on CT scan. She underwent placement of an esophageal stent in the airway that rapidly migrated to the carina and had to be removed. The decision to transfer to our center was made. She arrived intubated with a wire-reinforced endotracheal tube (ETT).