12 January 2023 : Case report
[In Press] Malignant Melanoma Arising from Esophageal Melanosis and Synchronous with Esophageal Squamous Cell Carcinoma
Rare diseaseYoshihiro Ota1E, Kenichi Iwasaki1B, Kenta Miyoshi1B, Masaya Enomoto1B, Tesshi Yamada1G, Yuichi Nagakawa1A
Am J Case Rep In Press; DOI: 10.12659/AJCR.938617
Available online: 2023-01-12, In Press, Corrected Proof
Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule
Primary malignant melanoma of the esophagus is a rare disease. However, its exact etiology and progression from melanosis to malignant melanoma have not been elucidated due to its rarity.
We report a case of esophageal melanosis that progressed to malignant melanoma and was synchronous with esophageal squamous cell carcinoma. A male patient in his 60s was diagnosed with right hypopharyngeal cancer. Cervical dissection and chemoradiation therapy were performed. Esophageal melanosis was discovered using gastrointestinal endoscopy during a pre-treatment screening 2 years later and revealed a 0-Ia tumor in the middle thoracic esophagus, coinciding with the esophageal melanosis site. A biopsy revealed malignant melanoma. We performed thoracoscopic total thoracic esophagectomy. The resected specimen showed a 0-Ia lesion, and the invasion depth of the esophageal malignant melanoma was submucosal (pT1b-SM3), N0, Stage I. A 0-IIc lesion was found in the resected specimen [squamous cell carcinoma in situ, intraepithelial mucosal (pTis/T1a-EP), N0, Stage 0]. The patient has been recurrence-free for 18 months post-surgery without postoperative adjuvant chemotherapy and is still receiving outpatient followup.
The close relationship between esophageal melanosis and primary malignant melanoma of the esophagus has implicated the melanosis as the origin of the malignant melanoma. The coexistence of esophageal melanosis and esophageal cancer warrants improved patient followup, including biopsy and multiple endoscopic examinations after esophageal melanosis diagnosis.
Keywords: Esophagus; Melanoma, Cutaneous Malignant; Esophageal Squamous Cell Carcinoma
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