Posterior mediastinal melanoma causing severe dysphagia: a case report

Area of Science:

• Oncology
• Gastroenterology

Background:

• Describes a unique case of progressive severe dysphagia.
• The dysphagia was caused by a posterior mediastinal metastatic melanoma of unknown primary origin.

Purpose of the Study:

• To report an unprecedented case of metastatic melanoma presenting as a posterior mediastinal mass causing severe dysphagia.
• To discuss the diagnostic challenges and implications of nodal melanoma of unknown origin.

Main Methods:

• A case of progressive severe dysphagia was investigated.
• The patient underwent complete resection of a large posterior mediastinal mass.
• Immunohistochemistry was used for pathological assessment of the resected tumor.

Main Results:

• The mass was identified as a metastatic melanoma within a posterior mediastinal lymph node.
• The origin of the primary melanoma remained unknown.
• The presentation mimicked a neurogenic tumor with esophageal involvement.

Conclusions:

• This case represents the first reported instance of posterior mediastinal lymph node melanoma causing severe dysphagia.
• The unusual nodal origin necessitates careful exclusion of a primary cutaneous or mucosal melanoma.
• The diagnosis of primary nodal melanoma is challenging and relies heavily on the absence of disease elsewhere.