Primary Malignant Melanoma of the Esophagus, Treated with Immunotherapy: A Case Report

Rochefort, Pauline; Roussel, J; Fouchardière, Arnaud de la; Sarabi, Matthieu; Desseigne, Françoise; Guibert, Pierre; Cattey-Javouhey, Anne; Mastier, Charles; Neidhardt-Bérard, Eve-Marie; Fouchardière, Christelle De La

doi:10.2217/imt-2018-0011

Cited by 13 publications

(10 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These agents have been reported to demonstrate a substantial clinical benefit for patients with metastatic melanoma with objective response rates of 31.0–40.0% (22–24). In addition, several single case reports suggested that the usefulness of immunotherapy with nivolumab for PMME may be comparable to melanoma of other organs (6,25,26). Additional studies with larger sample sizes are needed to establish the evidence for immune-checkpoint inhibitor therapy for PMME.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics and survival of primary malignant melanoma of the esophagus

et al. 2019

View full text Add to dashboard Cite

Primary malignant melanoma of the esophagus (PMME) has been reported to be a rare and highly malignant disease, and to date a standard treatment strategy has not been established due to limited evidence. The aim of the present study was to investigate the clinicopathological characteristics of this extremely rare disease. A total of 6 out of 2,093 patients with PMME treated in our institution between 1995 and 2016 were retrospectively analyzed and their clinicopathological parameters including treatment course and long-term survival were investigated. The major clinicopathological characteristics of patients were that they were >70 years of age, male sex, dysphagia at first diagnosis, and macroscopic black protruding tumors located in the lower third of the thoracic esophagus. Four of the five patients receiving pretherapeutic endoscopic biopsy were correctly diagnosed with PMME, and two patients received preoperative treatment with ineffective histopathological responses. There were two unresectable cases, one was treated with an immune-checkpoint inhibitor and the other received palliative care. Three of the four patients receiving curative surgery developed hematogenous recurrence within two years of surgery and only one patient with pT1aN0M0 achieved long-term survival. The median overall survival of all six patients was 19.6 (6.4–40.5) months. Patients with stage I disease exhibited significantly more favorable prognoses than those with stage II–IV (P=0.025) and surgically-treated patients had significantly better prognoses than those who did not receive surgery (P=0.018). In conclusion, PMME was associated with highly malignant features and tended to develop hematogenous metastases even after radical resection. Early diagnosis appears to be important to cure this refractory disease.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics and survival of primary malignant melanoma of the esophagus

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The studies on the effects of radiotherapy, chemotherapy, and immunotherapy were inconsistent; some cases reported survival benefits [19–23] ; and others did not reach the same conclusion. [2,5,24] Currently, the main treatment for PMME is surgical excision. [3] Radical resection is also the main treatment for early poorly differentiated stomach adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

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

Li¹,

Liu²,

Wang³

et al. 2019

Medicine

View full text Add to dashboard Cite

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.

show abstract

“…18 Immune checkpoint inhibitors are also reportedly important options for melanoma treatment, 16 and some studies have noted the antitumor efficacy of these agents in PMME, even though most described only a single case. 19,20 In our cohort, nivolumab, pembrolizumab, and/or ipilimumab was administered to 3 patients, and one lived a relatively long time compared to other patients in our cohort. While our results are essentially anecdotal and should be interpreted with caution, immune checkpoint inhibitors might be the treatment of choice for esophageal melanoma, if available.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological presentations and surgical outcomes of esophageal melanoma

Urabe

Haruta

Ohkura

et al. 2019

Asian Cardiovasc Thorac Ann

View full text Add to dashboard Cite

Background Primary malignant melanoma of the esophagus is a rare tumor with a poor prognosis; the optimal treatment strategy has yet to be established. This study aimed to clarify clinical features, courses, and outcomes of patients undergoing surgical resection of primary malignant melanoma of the esophagus. Methods Six patients with primary malignant melanoma of the esophagus, in whom the absence of other primary melanomas had been confirmed, were selected from the medical database maintained in Toranomon Hospital. Their clinicopathological characteristics and long-term outcomes were retrospectively reviewed and analyzed. Results All 6 patients (five males and one female) underwent radical esophagectomy with three-field regional lymphadenectomy, and none received neoadjuvant therapy. Tumor invasion was classified into T1 in 5 (83%) cases and T3 in one (17%). Four (67%) patients had nodal metastases (one N1, one N2 and two N3). No distant metastatic lesions were detected preoperatively in any of our cases. Postoperative surveillance revealed recurrence in all 6 patients, and 5 (83%) died of the disease. The median overall survival was 24 months. One patient with a T3N3M0 tumor was treated after surgery with a dacarbazine-nimustine-vincristine regimen followed by irradiation for bone recurrence and survived for 87 months postoperatively. Another patient with a T1N3M0 tumor who survived for 27 months after liver and bone recurrence was treated with nivolumab, ipilimumab, and dacarbazine. Conclusion Although the courses of patients with primary malignant melanoma of the esophagus were consistently unfavorable, surgical resection with multidisciplinary therapeutic modalities may prolong survival in some cases.

show abstract

Primary Malignant Melanoma of the Esophagus, Treated with Immunotherapy: A Case Report

Cited by 13 publications

References 23 publications

Clinicopathological characteristics and survival of primary malignant melanoma of the esophagus

Clinicopathological characteristics and survival of primary malignant melanoma of the esophagus

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

Clinicopathological presentations and surgical outcomes of esophageal melanoma

Contact Info

Product

Resources

About