GASTROENTEROLOGICAL ENDOSCOPY
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
A RESECTED CASE OF SUPERFICIAL PRIMARY ESOPHAGEAL MALIGNANT MELANOMA THAT HAD BEEN DETECTED AT A HEALTH CHECK-UP
Masanari SHIMADA Susumu AMAYAYousuke KATOUDaiki KAKIUCHIKenichirou SAITOUYoshihiro TAKASHIMAYoshinori MUNEMOTOTakeshi MITSUIYoshiko SUDOUYasuji NAKANUMA
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2019 Volume 61 Issue 9 Pages 1636-1642

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Abstract

A 59-year-old male with a circumferential and superficial blackish brown lesion in the middle and lower thoracic esophagus that had been recognized at a health check-up, was diagnosed with malignant esophageal melanoma based on endoscopic biopsy.

The lesion was widespread Type 0-Ⅱb, and positron emission tomography (PET)/computed tomography (CT) showed no lymph node metastasis nor metastasis to other organs. Then, we determined that radical operation would be effective, and the patient underwent thoracoscopic subtotal esophagectomy in the prone position with three-field lymph node dissection. Microscopic findings of the resected specimen confirmed the presence of atypical cells with melanin deposition basally located in stratified squamous epithelium. Immunostaining revealed that atypical melanocytes had spread 16.4 centimeters in the longest diameter beyond the grossly visible blackish area. Dissected lymph nodes were negative for metastatic dissemination, and he was diagnosed with T1a-LPM N0M0; Stage 0.

No adjuvant chemotherapy was administered, and we continue to follow the patient carefully. At the one-year postoperative follow-up visit, no evidence of recurrence has been found. It is extremely rare that primary malignant esophageal melanoma is limited to the mucosa and resected at an early stage. Early detection of esophageal malignant melanoma with highly accurate endoscopic examination is important.

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© 2019 Japan Gastroenterological Endoscopy Society
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