Primary malignant melanoma of esophagus treated with endoscopic mucosal resection and esophagectomy.

摘要

A 74-year-old male with a long-standing history of chronic lymphocytic leukemia presented with dyspepsia. Upper endoscopy showed a subtle bluish 3-5-mm discoloration in the esophageal mucosa at approximately 20 cm from the incisors (Fig. 1). Biopsies demonstrated melanoma in situ and focal invasion into the superficial sub-mucosa, associated with melanosis, and consistent with primary esophageal melanoma (PMME, Fig. 2a, b). The cells stained positive for S-100 and MART-la, which confirmed PMME. In an attempt to stage and treat the lesion, endoscopic mucosal resection (EMR) was done using the band and snare method. Pathology revealed an extensive in situ melanoma and a small cluster of invasive melanoma at one margin of excision within the sub-mucosa.