Paraffin wax plombage was one of several plombage operations used for pulmonary tuberculosis about 40 years ago, and Shepherd included seven patients treated with wax plombage in her review of plombage in 1985. We describe another patient with wax plombage who coughed up wax 28 years after plombage, followed by much larger amounts of wax 15 years later. The pieces of wax were like worms and spirals, and we discuss possible causes for these shapes.