Surgical Treatment of Primary Malignant Melanoma of the Esophagus : A Case Report

Abstract

Primary malignant melanoma of the esophagus (PMME) is an extremely rare tumor with only scattered cases reported. Although surgical resection has been considered as the best possible option, the prognosis has been nonetheless poor. We report a case of PMME which was treated by surgical resection and additionally followed by chemotherapy. A 60-yr-old man underwent an esophagoscopy due to a 3-month history of dysphagia and upper abdominal discomfort. A pigmented polypoid mass in the lower third of the esophagus was discovered, and a biopsy identified the mass as a malignant melanoma. Consequently, a subtotal esophagectomy and intrathoracic esophagogastrostomy was carried out. At follow-up four months after discharge, lymph node enlargements in the cervical area and celiac axis area were found. As a result, the patients was started on systemic chemotherapy treatment, which included Dacarbazine. The patient has been doing well and is now 35 months post-operative.

The Thousand Faces of Malignant Melanoma: A Systematic Review of the Primary Malignant Melanoma of the Esophagus

“…After other reports [ 178 , 179 , 180 , 181 , 182 , 183 , 184 , 185 , 186 , 187 ], Fredricks et al [ 188 ] reported an extremely rare case of PMME in a patient with human immunodeficiency virus (HIV) for more than 10 years. Interestingly, the operative esophagectomy specimen had the largest mass represented by the MM, but also two other pigmented lesions that were further away from the largest mass.…”

Presumed primary malignant melanoma of the liver: a case report

“…Nevertheless, since apparent macromorphologic findings are essential for diagnosing such digestive melanomas, reports are extremely limited. A review of the literature within the limits of published dates reported approximately 250 cases of malignant melanoma of the esophageal origin, 4 cases of the gastric origin, 18 cases of the small bowel origin, 26 cases of the gallbladder origin, 14 cases of the bile duct origin, and 2 cases of the hepatic origin [1,2,5,6,[10][11][12][13]. In contrast, malignant melanoma has been reported to metastasize to the digestive tract (1-4%), gallbladder (15-20%), and bile duct (6%) [14][15][16].…”

Huge primary malignant melanoma of the esophagus: A case report and literature review

“…PMME grows vertically along the esophageal mucosa and is accompanied by latent extensive mucosal lesions . The resection altitude should be broader than that of esophageal cancer . Therefore, total or subtotal esophageal resection is suggested, regardless of any segment lesion that can improve five‐year survival .…”

“…The resection altitude should be broader than that of esophageal cancer . Therefore, total or subtotal esophageal resection is suggested, regardless of any segment lesion that can improve five‐year survival . The first radical surgery is the most important and constructive, once distant metastasis is confirmed and no contraindications exist.…”