This video presents two patients who were admitted with signs of suffocation due to acute pharyngeal obstruction. 1. A 78-year-old man required intubation and ventilatory support for 24 hours. He suffered orthopnea, episodes of apnea, slept sitting up and with nasal O2. The CT scan showed an extensive retro-pharyngeal mass from the base of the tongue that ran from the right to the left jugulo-carotid bundle and descended through the posterior mediastinum to the aortic arch. Excision for an oblique cervicotomy cured him of his symptoms. The lipoma measured 14 * 12 * 6 cm and harbored a 2 cm diameter liposarcoma. 2. A 66-year-old man required emergency tracheomy due to suffocation. The CT scan shows the cervical subcutaneous air of the tracheostomy and a retropharyngeal mass that enters the larynx and compresses the right vocal cord. Surgery through a left cervical incision allowed excision and the patient is asymptomatic. It harbored a 19 * 3 cm lipoma. Both patients with no close family relationship live in the same town of 6,000 inhabitants. Retropharyngeal lipomas are extremely rare. There are only 83 described in this location. The causes of admission in 6 patients were suffocation and coma. One described case caused the death of a 34-year-old boy. .

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