A 34-year-old non-hypertensive, obese female with a history of smoking, asthma, fibromyalgia presented at the ED with hemoptysis, dyspnea, and emesis for two weeks. At presentation the patient was afebrile, vital signs were stable and labs showed unremarkable CBC and BMP. Chest X-ray showed an abnormal soft tissue density within the subcarinal region. A follow-up chest CT with contrast revealed a posterior mediastinal mass measuring 5.4 cm x 3.6 cm in size with well-circumscribed borders. The patient was referred to cardiothoracic surgery for complete excision of the mass. She underwent robotic-assisted posterior mediastinal mass resection.