[A case of multiple primary malignant melanoma of the esophagus]

A case of multiple primary malignant melanoma of the esophagus was reported. A 66-year-old male was referred to the hospital with complaints of appetite loss and dysphagia. A barium swallow revealed two polypoidal tumors of approximate equal size, one in the lower third of esophagus and the other in the cardiac region of stomach. The tumors were shown blackish at endoscopy and biopsy yielded a histological diagnosis of malignant melanoma. Abdominal CT, abdominal ultrasonography and hepatic arteriography showed metastasis to liver and rt paracardiac lymph nodes. However, no primary lesion of malignant melanoma but esophagus was found through the preoperative clinical examination. Partial resection of the esophagus along with the proximal of stomach and the paracardiac lymph nodes was performed. Microscopically, the typical finding of junctional activity adjacent to the tumor mass was not obtained but we diagnosed as primary esophageal tumor because melanocytes were present along the basal layer of normal esophageal mucosa and groups of melanophages were found in the submucosal layer. However, we could not conclude which polypoidal tumor was the primary lesion. The patient received systemic chemotherapy postoperatively and is alive 5 months after surgery.