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A 50-year-old man presented with a 4- day history of cough on eating and drinking. He was known to have an oesophageal carcinoma for which he had received chemotherapy and radiotherapy initially and latterly dilatation and laser therapy. Oesophagoscopy revealed the tumour to be at 20–25 cm with a 6–8 mm tracheoesophageal fistula at 22 cm, which was treated by insertion of a Celestin oesophageal stent under sedation with midazolam and pethidine. Insertion of the stent was uncomplicated, but immediately afterwards the patient experienced severe dyspnoea and stridor so emergency anaesthetic assistance was sought.

Lymphoepithelioma-like carcinoma (LEC), an undifferentiated carcinoma with pronounced lymphocytic infiltration, often is seen in the nasopharynx as well as in other areas. But such primary pulmonary lung neoplasms in children are rare, and we present the first reported case of primary pulmonary LEC in a child.