2019 Volume 34 Issue 1 Pages 35-40
We report two cases of malignant melanoma of the esophagus treated with nivolumab.
Case 1 involves a 60－year－old man diagnosed in 2015. The cancer cell lines showed a wild－type BRAF mutation. Nivolumab was started because of multiple metastasis to the retroperitoneum and mesentery. Although the peritoneal lesions disappeared, the primary tumor and regional lymph node metastases persisted. Subsequently, subtotal esophagectomy with lymph node dissection was performed. Nivolumab was restarted after surgery ; however, brain metastasis was observed. Despite replacing nivolumab with ipilimumab and performing whole brain irradiation, the patient died.
Case 2 involves a 72－year－old woman who was diagnosed in 2015. Cancer cells obtained from the patient also showed a wild－type BRAF mutation. Combined positron－emission tomography and computed tomography revealed L2 vertebral body metastasis. Although the metastatic lesion disappeared after treatment with nivolumab, among the primary lesions, only pigmented lesions were affected. Despite continuation of nivolumab, the esophageal primary lesion recurred. Subsequently, subtotal esophagectomy with lymph node dissection was performed. Thus far, no evidence of cancer recurrence without treatment has been reported in this case.[Skin Cancer (Japan) 2019 ; 34 : 35－40]
