Published online Nov 14, 2024. doi: 10.3748/wjg.v30.i42.4557
Revised: September 29, 2024
Accepted: October 14, 2024
Published online: November 14, 2024
Processing time: 97 Days and 10 Hours
Esophageal melanosis (EM) is a rare condition characterized by melanin pigmentation in the esophageal mucosa. It is not well understood and has been documented in less than 100 cases worldwide.
We report two cases of African American patients who complained of significant weight loss (over 20 pounds in approximately six months) and abdominal pain during their first visit. The first case involves a 54-year female with a history of hepatic steatosis and polysubstance abuse, who also experiences nausea and vomiting. The second case is a 59-year-old male with hypertension and gastroesophageal reflux disease (GERD), who was diagnosed with esophageal squamous cell carcinoma. Both cases show benign melanocytes in the basal layer on the esophagus biopsy and are diagnosed as EM.
It is important to note that EM has been associated with malignancies such as carcinoma and melanoma. Therefore, accurate diagnosis and appropriate management are crucial. Patients with EM, especially those with concurrent risk factors (e.g., GERD, smoking), should be carefully monitored for any signs of malignancy.
Core Tip: Esophageal melanosis is a rare condition. Its causes and natural progression are not fully understood. Some studies have reported an association with malignancy and as a potential precursor for malignancy. Extended research is required to establish an additional correlation for this rare entity.