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Japanese Journal of Clinical Oncology 2008 38(3):233; doi:10.1093/jjco/hyn018
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© The Author (2008). Published by Oxford University Press. All rights reserved

A Case of Primary Malignant Melanoma of the Esophagus

Noriaki Kanamori and Hiroyasu Igaki

Esophageal Surgery Division
National Cancer Center Hospital
Tokyo, Japan

A 70-year-old man, presenting with progressive dysphasia, was referred to our institute under the diagnosis of primary malignant melanoma of the esophagus (PMME). Esophagoscopy revealed an irregular tumor, measuring 12 cm in diameter, surrounded by pigmented mucosa in the middle esophagus. The tumor was very friable and easily had contact hemorrhage during endoscopic biopsy (Fig. 1; a colour version of this figure is available as supplementry data at http://www.jjco.oxfordjournals.org). Upper gastrointestinal Barium study showed a large, polypoid tumor longitudinally expanding to the lower esophagus without completing the obstruction of the esophagus (Fig. 2). Extensive examination revealed no other skin, anal, facial or rectal lesions. On the basis of histological and immunohistochemical studies, a diagnosis of PMME was made: tumor cells were intensively positive for immunohistochemical staining (HMB-45+). Then, the patient underwent transthoracic esophagectomy with three-field lymphadenectomy and adjuvant chemotherapy. However, he developed bowel obstruction cause by intra-abdominal recurrence of melanoma 10 months after surgery.


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PMME is a rare malignant disease, accounting for only 0.1–0.2% of all esophageal neoplasms, and the prognosis is very poor. Surgical resection is currently the treatment of choice for this disease. Because PMME shows submucosal spreading, it is mandatory to perform radical surgical resection, not endoscopic mucosal dissection.


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This Article
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