Primary malignant melanoma of the oesophagus: two case reports

Primary malignant melanoma of the oesophagus is a rare and aggressive malignancy. This tumour entity accounts for 0.1-0.2% of all oesophageal malignancies and risk factors are yet to be established, although melanosis of the oesophagus may reflect its precursor form. Dysphagia is the commonest symptom. On gastroscopy, it appears as an elevated pigmented mass with satellite lesions in some cases. Unfortunately, most patients present late with metastatic disease. The prognosis is poor with a mean survival time post-operatively of 10-14 months and a 5-year survival rate of 4.5%. Although adjuvant therapy offers some loco-regional control, complete surgical resection offers the best hope for survival.