Clinicopathological characteristics, staging classification, and survival outcomes of primary malignant melanoma of the esophagus

Sun, Haiyan; Gong, Lei; Zhao, Gang; Zhan, Hongdian; Meng, Bin; Yu, Zhentao; Pan, Zhanyu

doi:10.1002/jso.24905

Cited by 21 publications

(28 citation statements)

References 41 publications

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“…The PMME most commonly occurs in males, and the male-to-female ratio is 2:1, only 5 female patients were recorded in this study, which was similar to previous studies. [ 9 , 13 ] In the present study, there were 8 patients who failed to obtain accurate diagnosis by endoscopic biopsy before operation, including 3 cases of squamous cell carcinoma, 2 cases of adenocarcinoma, and 3 cases of malignant tumor. It was worth noting that among the 11 patients with PMME diagnosed by endoscopic biopsy before operation, 8 cases underwent immunohistochemical examination, which also suggested that immunohistochemical examination was of great significance in the diagnosis before operation.…”

Section: Discussionmentioning

confidence: 73%

“…Previous studies have shown that LNM was an independent prognostic factor in patients with esophageal squamous cell carcinoma. [ 13 , 17 – 19 ] Similarly, Wang et al analyzed the data of 13 PMME patients and also found that patients with LNM had a poor prognosis. [ 20 ] The present study found that patients with LNM had shorter OS time than that of without LNM.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics and prognosis of primary malignant melanoma of the esophagus

Chen

Sun

2020

Medicine

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Primary malignant melanoma of esophagus (PMME) is a rare malignant tumor of esophagus. This study aimed to investigate the clinic pathologic characteristics and analyze the factors that might affect the prognosis of PMME patients. A total of 20 PMME patients who underwent surgical treatment in our hospital from 1975 to 2017 were analyzed. The clinical data, surgical and pathologic features of all patients were collected. For 20 PMME patients, the average age was 57.3 ± 10.7 years, and the male patients account for 75%. Most of the tumors (95%) were located in the middle and lower of the esophagus. There were 7 patients with primary tumor invasion beyond the muscular layer (T3 + T4) and 10 patients with lymph node metastasis (LNM). The median survival time of 20 patients was 12 months, and the 1-year and 5-year survival rates were 50% and 16.9%, respectively. The probability of LNM in tumors confined to submucosa (T1) and myometrium (T2) was lower than that in tumors with deeper invasion (T3, T4) ( P = .035). Multivariate analysis showed that tumor node metastasis (TNM) staging was the independent prognostic factor for survival of PMME patients (hazard ratio [95% confidence interval], 4.15 [1.36–12.67]; P = .012). For PMME patients, tumors with deeper invasion were more likely to have LNM, and TNM staging was an independent predictor of prognosis for survival. Early detection of the disease and radical resection of the tumor are critical for better survival of the PMME patients.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Characteristics and prognosis of primary malignant melanoma of the esophagus

Chen

Sun

2020

Medicine

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“…A previous study reported that the accuracy of biopsy is approximately 80%, and 20–50% of patients were misdiagnosed with poorly differentiated carcinoma because of absence of melanin granules [ 1 ]. Sun et al considered the reasons for misdiagnosis as follows: 1) some tumors are grossly amelanotic, and contain no melanin granules that are observable through microscopy, 2) melanocytes tend to concentrate in foci, and may thus be missed on biopsy, and 3) primary esophageal melanoma may be covered by normal squamous epithelium [ 16 ]. In our case, a detailed re-examination of biopsy tissue later revealed melanin with hematoxylin–eosin stain.…”

Section: Discussionmentioning

confidence: 99%

Primary esophageal malignant melanoma successfully treated with anti-PD-1 antibody for retroperitoneal recurrence after esophagectomy: A case report

Endo

Akiyama

Onishi

et al. 2020

International Journal of Surgery Case Reports

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“…As a noncutaneous melanoma, PMME has been occasionally reported since 1906. [2] To date, about 337 cases of esophageal melanoma have been published, [4,8] whereas copresentation with gastric cancer has not been reported.…”

Section: Discussionmentioning

confidence: 99%

“…Malignant melanoma occurs mostly in the skin and primary malignant melanoma of the esophagus (PMME) is very rare, accounting for approximately 0.1% to 0.2% of all esophageal tumors and 0.5% of all noncutaneous melanomas. [1,2] The average age of the patients with PMME is 60.5 years and the ratio of men to women is 2:1. [3] Along with the high aggressiveness of the disease, the median survival time of PMME is 13.4 months and 5-year overall survival rate is around 4%, [4,5] the rate may be improved to 37.5% after surgical resection according to a recent study.…”

Section: Introductionmentioning

confidence: 99%

Malignant melanoma of the esophagus complicated with poorly differentiated mucinous adenocarcinoma of the stomach

Li¹,

Liu²,

Wang³

et al. 2019

Medicine

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Rationale:Primary malignant melanoma of the esophagus (PMME) is a rare malignancy that only accounts for <2% of all primary esophageal tumors. Here, we report the even rarer occurrence of PMME in combination with poorly differentiated mucinous adenocarcinoma of the stomach.Patient concerns:A 64-year-old man was presented to the hospital with >1 month of eating dysphagia. Enhanced computed tomography (CT) scan only found a space-occupying lesion in the lower esophagus with moderate enhancement. However, gastroscope showed not only esophageal masses, but also gastric mucosa changes.Diagnoses:Poorly differentiated mucinous adenocarcinoma and PMME were diagnosed based on pathological biopsy and immunohistochemical methods.Interventions:The patient underwent laparoscopic gastric cancer radical surgery, esophageal resection, and colonic replacement of the esophagus.Outcomes:Abdominal CT and esophagography performed 1 week after surgery showed that it was consistent with postoperative changes without other abnormalities. However, the patient died 3 months after discharge without receiving any other treatment.Lessons:This case suggests more attention should be drawn to the diagnosis of multiple primary malignant neoplasms in elder patients, and also highlights the need to fulfill comprehensive examinations before surgery in case of misdiagnosis. Besides, it is challenging to finding a reasonable treatment for such rare condition.

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Clinicopathological characteristics, staging classification, and survival outcomes of primary malignant melanoma of the esophagus

Abstract: PMME is a considerably aggressive tumor with poor prognosis. The staging classification of mucosal melanoma of the upper aerodigestive tract may be a good option for PMME patients.

Cited by 21 publications

References 41 publications

Characteristics and prognosis of primary malignant melanoma of the esophagus

Characteristics and prognosis of primary malignant melanoma of the esophagus

Primary esophageal malignant melanoma successfully treated with anti-PD-1 antibody for retroperitoneal recurrence after esophagectomy: A case report

Malignant melanoma of the esophagus complicated with poorly differentiated mucinous adenocarcinoma of the stomach

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