A 47-year-old man presented with a 2-day history of swelling in the right side of his neck after an upper respiratory infection. He also reported a history of a stable mass in the right side of his neck that had been self-monitored for 2 years without intervention. In the setting of a sore throat and cough, there was a sudden increase in the size of the mass, resulting in odynophagia and an acute episode of dyspnea. The patient denied associated tenderness, fevers, chills, weight loss, or night sweats. He also denied a history of antecedent trauma or neck surgery.