Flat-type primary malignant melanoma of the esophagus

Ueyama, Hiroya; Yao, Takashi; Matsumoto, Kenshi; Nakagawa, Yuta; Takeda, Tsutomu; Matsumoto, Keīichi; Nagahara, Akihito; Watanabe, Sumio

doi:10.1055/s-0042-106205

Cited by 8 publications

(8 citation statements)

References 12 publications

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“…[ 3 , 5 ] In contrast, metastatic melanoma usually has multiple nodular lesions and may be distributed in various parts of the gastrointestinal tract. [ 6 ] However, some PMMEs present as a flat lesion [ 7 ] or as multinodular lesions that are difficult to distinguish from metastatic lesions. [ 8 , 9 ] Surface pigmentation is characteristic of gastrointestinal melanoma, but some melanomas lack melanin—the so-called amelanotic melanomas; these account for 10% to 25% of all PMMEs and are extremely difficult to distinguish from other tumor types.…”

Section: Discussionmentioning

confidence: 99%

Primary malignant melanoma of the esophagogastric junction

2021

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Rationale: Most gastrointestinal melanomas are metastatic from an oculocutaneous primary lesion; however, primary gastrointestinal melanomas have been found in all levels of the gastrointestinal tract. We present the case of Primary malignant melanoma of the esophagus and discuss the diagnostic methods, differentiation from metastatic lesions and treatment options. Patient concerns: A 78-year-old male patient presented with fresh blood vomiting and tarry stools for 1 day. Diagnoses: Esophagogastroduodenoscopy of this patient revealed a tumor ∼4 cm in size at the cardia side of the esophagogastric junction with dark-red and gray pigmentation. Immunohistochemical stains of the biopsy specimens were positive for S-100 and HMB-45, which are specific markers of melanoma. Interventions: Laparotomy with proximal gastrectomy was performed by the surgeon. Histological examination of the surgical specimen revealed the tumor arose from the distal esophagus with invasion of the proximal stomach. Primary malignant melanoma of the esophagus was diagnosed after a full skin and ophthalmic examination and positron emission tomography, which revealed no lesions elsewhere in the body. Outcomes: No tumor recurrence was noted at the 1-year follow-up. Lessons: Primary malignant melanoma of the esophagus is an extremely rare but highly aggressive tumor. The special pattern of pigmentation should be recognized while performing endoscopy. Early detection and radical resection of the tumor are critical to ensure favorable outcomes.

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Section: Discussionmentioning

confidence: 99%

Primary malignant melanoma of the esophagogastric junction

2021

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“…Complete excision of localized metastatic melanoma (metastasectomy) can result in prolonged overall and relapse-free survival and is recommended for carefully selected patients 10, 11, 12. Although successful endoscopic removal of early-stage primary esophageal malignant melanoma with EMR13, 14 and ESD 15 have been reported, to our knowledge this is the first case report of a metastatic melanoma to the esophagus for which complete resection was performed with ESD. In this case, ESD was chosen to remove the lesion in en-bloc fashion with wide horizontal and vertical margins.…”

Section: Discussionmentioning

confidence: 94%

Endoscopic submucosal dissection of esophageal metastatic melanoma

Bazarbashi

Srivastava

et al. 2019

VideoGIE

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“…3 The endoscopic features of melanocytosis are flat dark brown lesions 3-5 mm in size with unclear borders. 4,5 In contrast, early-stage esophageal malignant melanoma endoscopically shows a black spot with clear borders and a smooth surface. [4][5][6][7] Typical endoscopic findings of superficial esophageal SCC are reddish on white light imaging and brownish areas with dot-like dilated vessels on narrow-band imaging endoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…One of three presented with a black spot with clear borders and slight thickening, consistent with early-stage malignant melanoma. [4][5][6][7] The remaining two dark brown spots indicated melanocytosis. Esophageal melanocytosis is found in 25%-30% of malignant melanoma cases.…”

Section: Discussionmentioning

confidence: 99%

Superficial esophageal squamous cell carcinoma with melanocytosis that was endoscopically difficult to differentiate from malignant melanoma

Horikawa,

Goda,

Koyanagi

et al. 2024

DEN Open

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Esophageal squamous cell carcinoma (SCC) with dark spots caused by melanocytosis is very rare. A reddish and flat lesion, 4 cm in length and covering over two‐thirds of the circumference, was found in the midthoracic esophagus of a 66‐year‐old male. Multiple brown and black spots are observed in the lesion. Superficial SCC with melanocytosis or malignant melanoma was also suspected. Endoscopic submucosal dissection was performed without biopsies of the spots. Histologically, a few melanocytes were observed in the black spots, and the lesion was diagnosed as SCC (T1a‐lamina propria mucosae) with melanocytosis. We report a case of esophageal SCC with dark black spots that were difficult to differentiate endoscopically from malignant melanoma.

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Flat-type primary malignant melanoma of the esophagus

Cited by 8 publications

References 12 publications

Primary malignant melanoma of the esophagogastric junction

Primary malignant melanoma of the esophagogastric junction

Endoscopic submucosal dissection of esophageal metastatic melanoma

Superficial esophageal squamous cell carcinoma with melanocytosis that was endoscopically difficult to differentiate from malignant melanoma

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