A 44-year-old female patient received proctocolectomy and chemotherapy for a diagnosis of colon cancer 10 years previously and presented here with new onset of cough for 2 months and a progressive increase of her serum CA19-9 level. F-FDG PET/CT imaging revealed a hypermetabolic lesion within the trachea. Immunostaining confirmed that this lesion was a metastatic adenocarcinoma that originated from the patient's initial colon cancer. F-FDG PET/CT enabled localization of unusual endotracheal metastasis and facilitated the development of an appropriate treatment plan.