Authors : B. Ravi Shankar; J. Kiran Kumar; B. Shruti Sagar; B. Vamsi Krishna; Sayeeda Asma Sultana; Sai Sindhu Naidu

Volume/Issue : Volume 9 - 2024, Issue 4 - April

Google Scholar : https://tinyurl.com/whfy5hyv

Scribd : https://tinyurl.com/3cx9tvf4

DOI : https://doi.org/10.38124/ijisrt/IJISRT24APR1796

Abstract : A 70 year old man having progressive dysphagia, coronary artery disease (CAD) with an Ejection Fraction (EF) of 30% was detected to have a poorly differentiated esophageal malignancy. Immunohistochemistry (IHC) was positive for HMB 45 and SOX 10 confirming esophageal melanoma. In view of advanced age and poor cardiac function, surgical treatment was not feasible. Palliative esophageal metallic stenting was performed. Immunotherapy was suggested with ICI. We present this case in view of rarity of esophageal melanoma and to stress the need for evaluation with IHC in subjects with poorly differentiated esophageal malignancy.

Keywords : PMME, Dysphagia, Immunotherapy, SEMS, Melanoma.

References :

1. Wang S, Tachimori Y, Hokamura N, Igaki H, Kishino T, Kushima R. Diagnosis and surgical outcomes for primary malignant melanoma of the esophagus: a single-center experience. The Annals of Thoracic Surgery. 2013 Sep 1;96(3):1002-6.
2. Iwanuma Y, Tomita N, Amano T, Isayama F, Tsurumaru M, Hayashi T, Kajiyama Y. Current status of primary malignant melanoma of the esophagus: clinical features, pathology, management and prognosis. Journal of gastroenterology. 2012 Jan;47:21-8.
3. Suganuma T, Fujisaki J, Hirasawa T, Ishiyama A, Yamamoto Y, Tsuchida T, Igarashi M. Primary amelanotic malignant melanoma of the small intestine diagnosed by esophagogastroduodenoscopy before surgical resection. Clinical Journal of Gastroenterology. 2013 Jun;6:211-6.
4. Suzuki Y, Aoyama N, Minamide J, Takata K, Ogata T. Amelanotic malignant melanoma of the esophagus: report of a patient with recurrence successfully treated with chemoendocrine therapy. International Journal of Clinical Oncology. 2005 Jun;10:204-7.
5. Harada K, Mine S, Yamada K, Shigaki H, Oya S, Baba H, Watanabe M. Long-term outcome of esophagectomy for primary malignant melanoma of the esophagus: a single-institute retrospective analysis. Diseases of the Esophagus. 2016 Jun 1;29(4):314-9.
6. Flaherty KT, Robert C, Hersey P, Nathan P, Garbe C, Milhem M, Demidov LV, Hassel JC, Rutkowski P, Mohr P, Dummer R. Improved survival with MEK inhibition in BRAF-mutated melanoma. New England Journal of Medicine. 2012 Jul 12;367(2):107-14.
7. Ota Y, Iwasaki K, Miyoshi K, Enomoto M, Yamada T, Nagakawa Y. Malignant Melanoma Arising from Esophageal Melanosis and Synchronous with Esophageal Squamous Cell Carcinoma. The American Journal of Case Reports. 2023;24:e938617-1.
8. Ohmori T. Esophageal melanosis. Shokaki Naishikyo (Endosc Dig). 1990;2:1158-9.
9. Sharma SS, Venkateswaran S, Chacko A, Mathan M. Melanosis of the esophagus: an endoscopic, histochemical, and ultrastructural study. Gastroenterology. 1991 Jan 1;100(1):13-6.
10. Chang F, Deere H. Esophageal melanocytosis morphologic features and review of the literature. Archives of pathology & laboratory medicine. 2006 Apr 1;130(4):552-7.
11. Kim TS, Min BH, Min YW, Lee H, Rhee PL, Kim JJ, Lee JH. Clinical characteristics and treatment outcomes of primary malignant melanoma of esophagus: a single center experience. BMC gastroenterology. 2022 Dec;22(1):1-0.
12. Dai L, Wang ZM, Xue ZQ, He M, Yuan Y, Shang XQ, Chen KN, Lin Y, Yan WP, Zhao JD, Guo SP. Results of surgical treatment for primary malignant melanoma of the esophagus: a multicenter retrospective study. The Journal of Thoracic and Cardiovascular Surgery. 2021 Jan 1;161(1):294-302.