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

Zhang, Lin; Ma, Wei; Li, Yun

doi:10.1111/1759-7714.12063

Cited by 7 publications

(6 citation statements)

References 11 publications

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“…In developing countries oesophageal cancer makes up approximately 80% of total cases and deaths (11,12). Oesophageal cancer histological type and its incidence differs depending on geographic locations.…”

Section: Introductionmentioning

confidence: 99%

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A multinational review: Oesophageal cancer in low to middle‑income countries (Review)

et al. 2020

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Oesophageal cancer (OC) is an aggressive neoplasm that manifests in the gastrointestinal tract and is the result of numerous factors that can contribute to the development of the disease. These may include old age, nutritional deficiencies, oesophageal obstruction and food ingestion difficulties. Environmental factors serve a large role in increasing the risk of developing OC. Two factors that serve an increasing risk of developing OC are the use of tobacco and the consumption of alcohol. Genetic factors also exhibit a large effect on the risk of developing OC, for example, the causative genes in Black Africans differ from other races. OC is 3-4 times more common among men than women. OC has been previously reported in >450 000 individuals worldwide, and its incidence is increasing. The current review compares OC in low to middle-income countries with developed countries. The incidence of OC, particularly squamous cell carcinoma (SCC) is high in low and middle-income countries. In developed countries, the incidence of SCC is low compared with adenocarcinoma. The majority of OC cases are diagnosed in the late stages of the disease, leading to high mortality rates. The current review aimed to discuss factors that contribute to the development of this disease in different geographical areas and genetic mechanisms governing these findings. The current review also aims to discuss the preventative treatment options for the disease, and also discusses the diagnosis and surveillance in five LMICs, including South Africa, China, Tanzania, India and Brazil. Contents 1. Introduction 2. Methods 3. Oesophageal cancer risk Factors 4. Epidemiology of oesophageal cancer 5. Oesophageal cancer in low to middle countries compared to developed countries 6. Molecular epidemiology of oesophageal cancer 7. Diagnosis and prognosis of oesophageal cancer 8. Oesophageal cancer treatment 9. Conclusions

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Section: Introductionmentioning

confidence: 99%

“…This data indicates that males are more affected than females in both well-developed and developing countries. The relative risk factors for developing oesophageal cancer depend on geographic locations as well as variations in histological types (Table II) (11,13).…”

Section: Introductionmentioning

confidence: 99%

A multinational review: Oesophageal cancer in low to middle‑income countries (Review)

et al. 2020

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“…From 2013 to 2016, other 35 cases of PMME were reported in literature [ 223 , 224 , 225 , 226 , 227 , 228 , 229 , 230 , 231 , 232 , 233 , 234 , 235 , 236 , 237 , 238 , 239 , 240 , 241 , 242 , 243 , 244 , 245 , 246 , 247 , 248 , 249 , 250 , 251 , 252 , 253 ] with a particular emphasis about the case presented by Zhang et al [ 228 ] that measured 12 cm (huge PMME).…”

Section: Discussionmentioning

confidence: 99%

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

Cazzato

Cascardi

Colagrande

et al. 2022

Cancers

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Primary Malignant Melanoma of the Esophagus (PMME) is an extremely rare cancer of the esophagus, accounting for 0.1–0.8% of all oro-esophageal cancers and <0.05% of all melanoma subtypes, with an estimated incidence of 0.0036 cases per million/year. We conduct a careful analysis of the literature starting from 1906 to the beginning of 2022, searching the PubMed, Science.gov, Scopus and Web of Science (WoS) databases. A total of 457 records were initially identified in the literature search, of which 17 were duplicates. After screening for eligibility and inclusion criteria, 303 publications were ultimately included, related to 347 patients with PMME. PMME represents a very rare entity whose very existence has been the subject of debate for a long time. Over time, an increasing number of cases have been reported in the literature, leading to an increase in knowledge and laying the foundations for a discussion on the treatment of this pathology, which still remains largely represented by surgery. In recent times, the possibility of discovering greater mutations in gene hotspots has made it possible to develop new therapeutic strategies of which nivolumab is an example. Future studies with large case series, with clinicopathological and molecular data, will be necessary to improve the outcome of patients with PMME.

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“…Dai et al reported a median disease-free survival of 5.9 months for 70 resected cases [3], and Wang et al reported a median relapse-free survival (RFS) of 4.5 months for 58 resected cases [1], indicating that the prognosis for resected cases was also poor. Although many papers, including our previous report [10], have reported on resection as the initial treatment of PMME, there are few reports describing treatment after recurrence [6][7][8][11][12][13][14]. According to previous reports, recurrence sites vary widely, and treatments such as surgery, chemotherapy, radiation therapy, and immunotherapy are used.…”

Section: Discussionmentioning

confidence: 99%

A case of long-term survival treated with three metastasectomies and two subsequent adjuvant nivolumab therapies for recurrent malignant melanoma of the esophagus

et al. 2022

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Background The treatment strategy for metastatic lesions of primary malignant melanoma of the esophagus (PMME) is currently determined on a case-by-case basis, based on the National Comprehensive Cancer Network (NCCN) guidelines for cutaneous melanoma. The NCCN guidelines state that resection should be considered in patients with resectable metastatic recurrence. Herein, we report a case of long-term survival treated with three metastasectomies and two subsequent adjuvant nivolumab therapies for the metastatic recurrence of PMME. Case presentation A 65-year-old female patient with PMME underwent thoracoscopic subtotal esophagectomy, gastric tube reconstruction via the posterior mediastinal route, and cervical esophagogastric anastomosis. Histopathological examination of the resected specimen revealed that the tumor was PMME with tumor invasion into the muscularis propria and no lymph node metastasis. At the age of 68 years, she developed intestinal invagination due to jejunal metastasis of malignant melanoma and underwent resection of the jejunum. Histopathological examination of the resected specimen revealed two metastases of malignant melanoma in the jejunum and one metastasis to the mesenteric lymph node. At the age of 75 years, a recurrence of malignant melanoma was found in the cervical esophagus. She underwent thoracoscopic mobilization of the gastric tube and esophagus followed by cervical esophagectomy and reconstruction with a free jejunum flap. She received 24 courses of nivolumab therapy for 1 year as a postoperative adjuvant therapy. Subsequently, at the age of 78 years, an enlarged left cervical lymph node and a mass in the right lower lobe of the lung were found. She underwent left cervical lymph node dissection and thoracoscopic wedge resection of the right lung. Histopathological examination of the resected specimens revealed that both tumors were metastases of malignant melanoma. At age 79 years, she received eight courses of nivolumab therapy as a second postoperative adjuvant therapy, with no sign of recurrence in a 9-month follow-up period after the third metastasectomy. Conclusion In cases of metastatic recurrence of PMME, aggressive resection of oligometastasis with postoperative adjuvant nivolumab therapy may result in long-term survival.

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

Cited by 7 publications

References 11 publications

A multinational review: Oesophageal cancer in low to middle‑income countries (Review)

A multinational review: Oesophageal cancer in low to middle‑income countries (Review)

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

A case of long-term survival treated with three metastasectomies and two subsequent adjuvant nivolumab therapies for recurrent malignant melanoma of the esophagus

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