Primary rhabdomyosarcoma of the diaphragm: an unusual cause of adolescent pseudo-achalasia.

We report an adolescent male who presented with progressive dysphagia. Barium examination and upper endoscopy revealed the presence of a smoothly tapered stricture at the lower end of a dilated oesophagus typical of achalasia. Further evaluation by computed tomography (CT), demonstrated the presence of a bulky infiltrating diaphragmatic mass encasing the lower oesophagus. CT guided biopsy of the mass and subsequent post mortem examination revealed the presence of a primary rhabdomyosarcoma of the diaphragm encasing the lower oesophagus. A diagnosis of pseudo-achalasia secondary to a primary diaphragmatic tumour was made.