Primary malignant melanoma of the esophagus: a case report

Primary malignant melanoma of the esophagus (PMME) is an extremely rare malignant tumor with a poor prognosis. PMME accounts for 0.1% to 0.2% of all malignant esophageal tumors. Owing to its rarity and heterogeneity, there is currently a lack of standardized diagnostic and therapeutic guidelines, making clinical management challenging. Herein, we report this case to describe its clinicopathological features, treatment strategy, and clinical course.

A 65-year-old Asian male patient presented with a two-month history of dysphagia. Upper gastrointestinal endoscopy revealed a large intraluminal mass in the middle to lower thoracic esophagus, and endoscopic biopsy suggested esophageal malignant melanoma. Postoperative histopathological and immunohistochemical examination confirmed malignant melanoma. Targeted physical evaluation of alternative potential primary sites and positron emission tomography/computed tomography (PET/CT) imaging revealed no additional primary lesions, supporting a primary esophageal origin. The patient underwent radical surgical resection followed by adjuvant chemotherapy, including nab-paclitaxel and carboplatin. At the final telephone follow-up approximately 28 months after surgery, no recurrence or distant metastasis was reported, and the patient maintained a good overall health status.

This case describes a favorable clinical course following microscopically margin-negative resection and individualized adjuvant chemotherapy in a patient with localized PMME. However, the contribution of adjuvant chemotherapy to the outcome remains uncertain, and further studies are needed to establish optimal postoperative management.