Large granular-cell myoblastoma of the oesophagus

A granular-cell tumour of the oesophagus, the largest hitherto described, was found in a 44-year-old woman. Histologic examination showed an infiltratively growing granular-cell myoblastoma without pleomorphism or mitotic activity. Local extirpation of the tumour was attempted in order to preserve oesophageal continuity. However, a tracheo-oesophageal fistula and stenosis of the previously tumour-bearing area developed and necessitated nasogastric tube feeding for 18 months. Two attempts to close the fistula, including resection of the fistula-bearing tracheal area, failed. Final cure was achieved by subtotal extirpation of the oesophagus and gastro-oesophageal anastomosis in the neck with the stomach placed retrosternally. Normal intake of food was restored after this operation and 30 months later the patient is doing well.