Current status of primary malignant melanoma of the esophagus: clinical features, pathology, management and prognosis
- 3 November 2011
- journal article
- review article
- Published by Springer Science and Business Media LLC in The Esophagus
- Vol. 47 (1), 21-28
- https://doi.org/10.1007/s00535-011-0490-y
Abstract
Primary malignant melanoma of the esophagus (PMME) is a rare disease with an extremely poor prognosis. Up to 2011, approximately 300 cases had been reported worldwide. The average age of onset is 60.5 years old, with a prevalence of males (2:1). A typical finding of PMME is a lobular or polyploid, well-circumscribed and pigmented tumor, partly covered with normal mucosa. PMME represents various colors depending on its melanin quantity and commonly coexists with intramural metastases, melanocytosis or melanoma in situ. The tumor is located from the middle to lower thoracic esophagus. The accuracy of diagnosis from biopsy is approximately 80%, because many cases are misdiagnosed as a poorly differentiated carcinoma because of the absence of melanin granules. A definite diagnosis was made by immunohistochemical examination with positive results of S100 protein, HMB45 and neuron-specific enolase. PMME has a highly metastatic potential, and the incidence of distant metastasis at the initial diagnosis is around 40–80%. A metastatic tumor from cutaneous malignant melanoma is another pigmented esophageal tumor to be considered when making the differential diagnosis for PMME. Junctional activity with melanotic cells in the adjacent epithelium and the presence of in situ melanoma and/or a satellite tumor without a previous history of cutaneous melanoma are definitive. Most of the reported patients were treated with radical esophagectomy, which is believed to be an effective approach for localized PMME. Five-year survival rates have been achieved in 37% recently, while adjuvant therapy has not been proven to increase overall survival but plays a palliative role.This publication has 52 references indexed in Scilit:
- A phase 2 trial of dasatinib in advanced melanomaCancer, 2010
- A phase II trial of nab‐paclitaxel (ABI‐007) and carboplatin in patients with unresectable stage IV melanomaCancer, 2010
- Immunotherapy for Melanoma: Current Status and PerspectivesJournal of Immunotherapy, 2010
- SLOW GROWING FLAT-TYPE PRIMARY MALIGNANT MELANOMA OF THE ESOPHAGUS TREATED WITH CAP-ASSISTED EMRDigestive Endoscopy, 2009
- Primary Malignant Melanoma of the Esophagus: Long-Term Survival After Radical ResectionJournal of Thoracic Oncology, 2009
- Japanese Classification of Esophageal Cancer, tenth edition: part IEsophagus, 2009
- Primary malignant melanoma of the oesophagusMelanoma Research, 2003
- Le mélanome malin primitif de l’œsophageAnnales de Chirurgie, 2001
- Treatment of Stage IV Malignant Melanoma with Dacarbazine, Carmustine, Cisplatin, and Tamoxifen Regimens: A University of South Florida and H. Lee Moffitt Melanoma Center StudyAnnals of Plastic Surgery, 1992
- Isolated Melanosis of the Esophagus: Systematic Endoscopic DiagnosisEndoscopy, 1990