Primary malignant melanoma of the esophagus with subtotal esophagectomy: a case report

Primary malignant melanoma of the esophagus (PMME) is a rare disease, comprising 0.1-0.2% of all malignant esophageal neoplasms. The most common symptoms include progressive dysphagia, chest and back pain, choking feeling and weight loss. PMME cannot be definitely diagnosed from clinical symptoms or CT examination, but can be confirmed by histological examination or a pathological examination. Immunohistochemical examination with positive results of S-100 protein and human melanoma black 45 (HMB45) makes a definitive diagnosis. Esophagectomy is the standard treatment for localized PMME. But the prognosis is poor. Inoperableness, metastases and insensitiveness of radiotherapy and chemotherapy in advanced tumors have led to poor prognosis. Here, we report a case of a 61-year-old male with progressive dysphagia for 1 month. After barium X-ray test, chest and abdomen computed tomography examination, upper gastrointestinal endoscopy and biopsy, the patient accepted esophagectomy, then the pathologic and immunohistochemical examination conformed the diagnosis of PMME.