Primary advanced esophago-gastric melanoma: A rare case

Figure 1 Upper gastrointestinal barium examination showed a large tumor blocking the esophago-gastric junction (A), esophagram showed a niche shadow in gastric fundus (B).

Figure 2 Computed tomography scan showed a soft mass in the esophago-gastric junction (A), enlarged lymph nodes in the lesser curvature of the stomach (B).

Figure 3 Endoscopic examination showed a black spot in the lower esophagus and a bulky black mass blocking the esophago-gastric junction (A), two black crater-like ulcers located at the fundus of the stomach (B).

Figure 4 Surgical specimen showed that the melanoma measured 3 cm × 6 cm in size with black pigmentation. There were several pigmented satellite nodules beside the main tumor lesion, the largest one being 1 cm × 1 cm in diameter. Two ulceration lesions were present at the fundus of the stomach.

Figure 5 Histological examination showed that the excised tumor tissue was composed of non-organized and pleomorphic cells exhibiting atypical nuclei, and abundant melanin granules. Hematoxylin-eosin staining, magnification × 400.

Figure 6 Immunohistochemical staining showed that the tumor was positive for S-100 (A), HMB-45 (B), melan-A (C), and Vimentin (D).