Granular cell tumour (GCT) is a rare benign tumour occurring, most commonly, in the head and neck. Multiple tumours occur in 5–16% of patients. These tumours are chemo-radio-resistant and have high recurrence rates despite their benign histopathological features. Traditional management, depending on access, involves total tumour resection with wide margins due to the high rates of recurrence with incomplete resection. We present a patient with two synchronous GCTs of their upper airway: in the larynx and the trachea. Complete excision of the supraglottic lesion would have rendered the patient's larynx incompetent. Therefore, after multidisciplinary team (MDT) discussion, and following a discussion with the patient regarding the risks and benefits, a novel surgical management approach was agreed. Subtotal CO2laser excision of the upper GCT was performed enabling functional organ preservation. A subsequent procedure was required when the patient became symptomatic due to tumour recurrence.

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