Hemoptysis is a common respiratory symptom causing a great deal of
anxiety. The cause is often apparent following a clinical history,
upper-airway examination, bronchoscopy, and CT scanning of the thorax.
We present a case of massive hemoptysis, the etiology of which was not
readily apparent despite this conventional approach. Vallecular
hemorrhage has been previously reported but is usually minor unless
associated with surgical trauma, and can be readily missed if not aware
of the possibility. We speculate about the etiology and mechanism for