|
1
|
Chaudhry A, Buluku G, Noor J, Chaudhari M, Suryanarayana C, Bigler S, Boyd S, Lee MP. A Rare Case of Primary Malignant Melanoma of the Esophagus Presenting as Dysphagia. ACG Case Rep J 2024; 11:e01405. [PMID: 39027157 PMCID: PMC11257670 DOI: 10.14309/crj.0000000000001405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 05/28/2024] [Indexed: 07/20/2024] Open
Abstract
Melanoma is one of the most notorious tumors due to its appearance in unusual locations. The most frequent site is the skin; however, it can sporadically develop as a primary tumor in the esophagus. However, as symptoms appear later, if the primary site is in the gastrointestinal system, it is frequently detected at the metastatic stage. We hereby describe a case of primary malignant melanoma of the esophagus that presented due to dysphagia with solid food and on further workup, found to be at the metastatic stage.
Collapse
Affiliation(s)
| | - Gabriel Buluku
- Department of Internal Medicine, St Dominic-Jackson Memorial Hospital, Jackson, MS
| | - Jawad Noor
- Department of Internal Medicine, St Dominic-Jackson Memorial Hospital, Jackson, MS
| | - M. Chaudhari
- Department of Internal Medicine, St Dominic-Jackson Memorial Hospital, Jackson, MS
- Department of Gastroenterology, Howard University Hospital, Washington, DC
- Department of Pathology, Baptist Hospital, Jackson, MS
- Department of Gastroenterology, University of Mississippi Medical Center, Jackson, MS
| | | | - Steven Bigler
- Department of Pathology, Baptist Hospital, Jackson, MS
| | - Stewart Boyd
- Department of Gastroenterology, University of Mississippi Medical Center, Jackson, MS
| | - Makau P. Lee
- Department of Gastroenterology, University of Mississippi Medical Center, Jackson, MS
| |
Collapse
|
|
2
|
Zhu ML, Wang LY, Bai XQ, Wu C, Liu XY. Primary malignant melanoma of the esophagus combined with squamous cell carcinoma: A case report. World J Gastrointest Surg 2023; 15:287-293. [PMID: 36896304 PMCID: PMC9988636 DOI: 10.4240/wjgs.v15.i2.287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/13/2022] [Accepted: 01/10/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Primary malignant melanoma of the esophagus is a rare malignant tumor of the esophagus, and its combination with squamous cell carcinoma is also rare. Here, we report the diagnosis and treatment of a case of primary esophageal malignant melanoma combined with squamous cell carcinoma.
CASE SUMMARY A middle-aged man underwent gastroscopy for dysphagia. Gastroscopy revealed multiple bulging esophageal lesions, and after pathologic and immunohistochemical analyses, the patient was finally diagnosed with "malignant melanoma with squamous cell carcinoma". This patient received comprehensive treatment. After one year of follow-up, the patient was in good condition, and the esophageal lesions seen on gastroscopy were controlled, but unfortunately, liver metastasis occurred.
CONCLUSION When multiple esophageal lesions are present, the possibility of multiple pathological sources should be considered. This patient was diagnosed with primary esophageal malignant melanoma combined with squamous cell carcinoma.
Collapse
Affiliation(s)
- Mei-Lin Zhu
- Department of Geriatrics, Jining No. 1 People's Hospital, Jining 272000, Sahndong Province, China
| | - Ling-Yun Wang
- Department of Gastroenterology, Jining No. 1 People's Hospital, Jining 272000, Shandong Province, China
| | - Xue-Qin Bai
- Department of Pathology, Jining No. 1 People's Hospital, Jining 272000, Sahndong Province, China
| | - Chen Wu
- Department of Gastroenterology, Jining No. 1 People's Hospital, Jining 272000, Shandong Province, China
- College of Clinical Medicine, Jining Medical University, Jining 272013, Shandong Province, China
| | - Xiang-Yu Liu
- Department of Gastroenterology, Jining No. 1 People's Hospital, Jining 272000, Shandong Province, China
| |
Collapse
|
|
3
|
Zhou SL, Zhang LQ, Zhao XK, Wu Y, Liu QY, Li B, Wang JJ, Zhao RJ, Wang XJ, Chen Y, Wang LD, Kong LF. Clinicopathological characterization of ten patients with primary malignant melanoma of the esophagus and literature review. World J Gastrointest Oncol 2022; 14:1739-1757. [PMID: 36187400 PMCID: PMC9516654 DOI: 10.4251/wjgo.v14.i9.1739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/24/2022] [Accepted: 07/26/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Primary malignant melanoma of the esophagus (PMME) is a rare malignant disease and has not been well characterized in terms of clinicopathology and survival.
AIM To investigate the clinical features and survival factors in Chinese patients with PMME.
METHODS The clinicopathological findings of ten cases with PMME treated at Henan Provincial People’s Hospital were summarized. Moreover, the English- and Chinese-language literature that focused on Chinese patients with PMME from 1980 to September 2021 was reviewed and analyzed. Univariate and multivariate analyses were employed to investigate the clinicopathologic factors that might be associated with survival.
RESULTS A total of 290 Chinese patients with PMME, including ten from our hospital and 280 from the literature were enrolled in the present study. Only about half of the patients (55.8%) were accurately diagnosed before surgery. Additionally, 91.1% of the patients received esophagectomy, and 88 patients (36.5%) received adjuvant therapy after surgery. The frequency of lymph node metastasis (LNM) was 51.2% (107/209), and LNM had a positive rate of 45.3% even when the tumor was confined to the submucosal layer. The risk of LNM increased significantly with the pT stage [P < 0.001, odds ratio (OR): 2.47, 95% confidence interval (CI): 1.72-3.56] and larger tumor size (P = 0.006, OR: 1.21, 95%CI: 1.05-1.38). The median overall survival (OS) was 11.0 mo (range: 1-204 mo). The multivariate Cox analysis showed both the pT stage [P = 0.005, hazard ratio (HR): 1.70, 95%CI: 1.17-2.47] and LNM (P = 0.009, HR: 1.78, 95%CI: 1.15-2.74) were independent prognostic factors for OS. The median disease-free survival (DFS) was 5.3 mo (range: 0.8-114.1 mo). The multivariate analysis indicated that only the advanced pT stage (P = 0.02, HR: 1.93, 95%CI: 1.09-3.42) was a significant independent indicator of poor RFS in patients with PMME.
CONCLUSION The correct diagnosis of PMME before surgery is low, and physicians should pay more attention to avoid a misdiagnosis or missed diagnosis. Extended lymph node dissection should be emphasized in surgery for PMME even though the tumor is confined to the submucosal layer. Both the LNM and pT stage are independent prognosis factors for OS, and the pT stage is the prognosis factor for DFS in patients with PMME.
Collapse
Affiliation(s)
- Sheng-Li Zhou
- Department of Pathology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou 450003, Henan Province, China
| | - Lian-Qun Zhang
- Department of Gastroenterology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou 450003, Henan Province, China
| | - Xue-Ke Zhao
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Yue Wu
- Department of Gastroenterology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou 450003, Henan Province, China
| | - Qiu-Yu Liu
- Department of Pathology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou 450003, Henan Province, China
| | - Bo Li
- Department of Radiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou 450003, Henan Province, China
| | - Jian-Jun Wang
- Department of Thoracic Surgery, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou 450003, Henan Province, China
| | - Rui-Jiao Zhao
- Department of Pathology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou 450003, Henan Province, China
| | - Xi-Juan Wang
- Department of Pediatrics, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou 450003, Henan Province, China
| | - Yi Chen
- Clinical Research Service Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou 450003, Henan Province, China
| | - Li-Dong Wang
- State Key Laboratory of Esophageal Cancer Prevention and Treatment, Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Ling-Fei Kong
- Department of Pathology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou 450003, Henan Province, China
| |
Collapse
|
|
4
|
Cazzato G, Cascardi E, Colagrande A, Lettini T, Resta L, Bizzoca C, Arezzo F, Loizzi V, Dellino M, Cormio G, Casatta N, Lupo C, Scillimati A, Scacco S, Parente P, Lospalluti L, Ingravallo G. The Thousand Faces of Malignant Melanoma: A Systematic Review of the Primary Malignant Melanoma of the Esophagus. Cancers (Basel) 2022; 14:3725. [PMID: 35954389 PMCID: PMC9367585 DOI: 10.3390/cancers14153725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 02/01/2023] Open
Abstract
Primary Malignant Melanoma of the Esophagus (PMME) is an extremely rare cancer of the esophagus, accounting for 0.1−0.8% of all oro-esophageal cancers and <0.05% of all melanoma subtypes, with an estimated incidence of 0.0036 cases per million/year. We conduct a careful analysis of the literature starting from 1906 to the beginning of 2022, searching the PubMed, Science.gov, Scopus and Web of Science (WoS) databases. A total of 457 records were initially identified in the literature search, of which 17 were duplicates. After screening for eligibility and inclusion criteria, 303 publications were ultimately included, related to 347 patients with PMME. PMME represents a very rare entity whose very existence has been the subject of debate for a long time. Over time, an increasing number of cases have been reported in the literature, leading to an increase in knowledge and laying the foundations for a discussion on the treatment of this pathology, which still remains largely represented by surgery. In recent times, the possibility of discovering greater mutations in gene hotspots has made it possible to develop new therapeutic strategies of which nivolumab is an example. Future studies with large case series, with clinicopathological and molecular data, will be necessary to improve the outcome of patients with PMME.
Collapse
Affiliation(s)
- Gerardo Cazzato
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (T.L.); (L.R.); (G.I.)
| | - Eliano Cascardi
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy;
- Pathology Unit, FPO-IRCCS Candiolo Cancer Institute, Str. Provinciale 142 lm 3.95, 10060 Candiolo, Italy
| | - Anna Colagrande
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (T.L.); (L.R.); (G.I.)
| | - Teresa Lettini
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (T.L.); (L.R.); (G.I.)
| | - Leonardo Resta
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (T.L.); (L.R.); (G.I.)
| | - Cinzia Bizzoca
- Section of General Surgery, Azienda Ospedaliero-Universitaria Policlinico di Bari, 70124 Bari, Italy;
| | - Francesca Arezzo
- Section of Gynecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (F.A.); (V.L.); (M.D.)
| | - Vera Loizzi
- Section of Gynecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (F.A.); (V.L.); (M.D.)
| | - Miriam Dellino
- Section of Gynecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (F.A.); (V.L.); (M.D.)
| | - Gennaro Cormio
- Oncology Unit IRCSS Istituto Tumori “Giovanni Paolo II”, Department of Interdisciplinary Medicine (DIM), University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Nadia Casatta
- Innovation Department, Diapath S.p.A., Via Savoldini n.71, 24057 Martinengo, Italy; (N.C.); (C.L.)
| | - Carmelo Lupo
- Innovation Department, Diapath S.p.A., Via Savoldini n.71, 24057 Martinengo, Italy; (N.C.); (C.L.)
| | - Antonio Scillimati
- Department of Pharmacy-Pharmaceutical Sciences, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Salvatore Scacco
- Department of Basic Medical Sciences and Neurosciences, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Paola Parente
- Unit of Pathology, Fondazione IRCCS Ospedale Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy;
| | - Lucia Lospalluti
- Section of Dermatology and Venereology, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Giuseppe Ingravallo
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.C.); (T.L.); (L.R.); (G.I.)
| |
Collapse
|