Primary Malignant Melanoma of the Esophagus: A Case Report

Abstract

Primary Malignant Melanoma of the Esophagus (PMME) is an aggressive tumor with a median survival of about 13 months. Surgical extirpation is the only treatment for PMME. The most common clinical presentation is the onset of progressive dysphagia. Endoscopy presents a polypoid lesion occasionally in the middle and lower third of the esophagus. Definitive diagnoses are based on pathology and immunohistochemical examination with positive results for S-100, Human Melanoma Black (HMB)-45, and Melanoma-specific Antigen (Melan-A) proteins. We presented a 46-year-old man complaining of dysphagia and melena from the past two months. Gasteroesophagoscopy demonstrated a large polypoid in the lower third of the esophagus extending to the cardia. Histopathology of the biopsy specimen from the esophagus revealed positive staining for S-100, Human Melanoma Black (HMB)-45, and Melanoma-specific Antigen (Melan A) proteins that were all compatible with malignant melanoma of the esophagus. The patient underwent surgery followed by radiotherapy and Immunotherapy. The postoperative period was uneventful. No metastasis and recurrence was observed after more than 6 months of initial treatment. PMME is a rare but highly aggressive tumor. The diagnosis of PMME should be made by clinical symptoms, auxiliary examination, pathological examination, and immunohistochemistry markers. The problem of exact diagnosis at the early stages of the disease and effective treatment is still a challenge.

Keywords

• Malignant melanoma
• Esophageal neoplasm
• Immunotherapy