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Amelanotic esophageal malignant melanoma: case report and short review of the literature.

Kranzfelder M, Seidl S, Dobritz M, BrĂ¼cher BL - Case Rep Gastroenterol (2008)

Bottom Line: Two months postoperatively, the planning CT scan for radiotherapy revealed progression of the retroperitoneal tumor mass, which was enclosing the celiac trunk, renal vein, and superior mesenteric artery.Multiple new liver and lung metastases were also found.At the end of May 2007, 4 months after the primary diagnosis, the patient died due to acute renal failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Technical University of Munich, Munich.

ABSTRACT
Malignant melanoma in the esophagus is a rare condition which has been described only occasionally in case reports or in larger series of patients with esophageal disease. We describe here the very rare case of a patient who presented initially with a 2-month history of dysphagia and weight loss which led to the endoscopic diagnosis of an unclear lesion in the distal esophagus. Biopsies were taken revealing positive immunohistochemical staining against HMB-45. As there were no signs of skin melanoma and there was an absence of pigmentation, a diagnosis of primary amelanotic malignant melanoma was made. Primary staging of the lesion was completed with computed tomography (CT), which revealed a locally advanced tumor with lymph node metastases at the lesser curvature of the stomach and celiac trunk. As there is still a lack of potential protocols for multimodal neoadjuvant treatment for this rare tumor entity, a palliative abdominothoracic esophagectomy with systemic lymphadenectomy and intrathoracic anastomosis was carried out. Due to an intraoperative R2 situation, clip marking was performed to allow postoperative radiotherapy. Two months postoperatively, the planning CT scan for radiotherapy revealed progression of the retroperitoneal tumor mass, which was enclosing the celiac trunk, renal vein, and superior mesenteric artery. Multiple new liver and lung metastases were also found. During the following weeks, the patient developed acute renal failure and was admitted for dialysis, and the planned radiotherapy was deferred. At the end of May 2007, 4 months after the primary diagnosis, the patient died due to acute renal failure.

No MeSH data available.


Related in: MedlinePlus

Computed tomography, showing an eccentric tumor mass in the esophageal wall and enlarged lymph nodes in the mediastinum, lesser curvature of the stomach, and surrounding the celiac trunk.
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Figure 2: Computed tomography, showing an eccentric tumor mass in the esophageal wall and enlarged lymph nodes in the mediastinum, lesser curvature of the stomach, and surrounding the celiac trunk.

Mentions: The further staging work-up included computed tomography of the chest and abdomen, tests for cardiac and pulmonary function, and laboratory tests, which were inconspicuous except for moderate left ventricular hypertrophy. Radiographic findings showed an eccentric tumor mass in the esophageal wall and enlarged lymph nodes in the mediastinum, at the lesser curvature of the stomach, and surrounding the celiac trunk (fig. 2).


Amelanotic esophageal malignant melanoma: case report and short review of the literature.

Kranzfelder M, Seidl S, Dobritz M, BrĂ¼cher BL - Case Rep Gastroenterol (2008)

Computed tomography, showing an eccentric tumor mass in the esophageal wall and enlarged lymph nodes in the mediastinum, lesser curvature of the stomach, and surrounding the celiac trunk.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3037985&req=5

Figure 2: Computed tomography, showing an eccentric tumor mass in the esophageal wall and enlarged lymph nodes in the mediastinum, lesser curvature of the stomach, and surrounding the celiac trunk.
Mentions: The further staging work-up included computed tomography of the chest and abdomen, tests for cardiac and pulmonary function, and laboratory tests, which were inconspicuous except for moderate left ventricular hypertrophy. Radiographic findings showed an eccentric tumor mass in the esophageal wall and enlarged lymph nodes in the mediastinum, at the lesser curvature of the stomach, and surrounding the celiac trunk (fig. 2).

Bottom Line: Two months postoperatively, the planning CT scan for radiotherapy revealed progression of the retroperitoneal tumor mass, which was enclosing the celiac trunk, renal vein, and superior mesenteric artery.Multiple new liver and lung metastases were also found.At the end of May 2007, 4 months after the primary diagnosis, the patient died due to acute renal failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Technical University of Munich, Munich.

ABSTRACT
Malignant melanoma in the esophagus is a rare condition which has been described only occasionally in case reports or in larger series of patients with esophageal disease. We describe here the very rare case of a patient who presented initially with a 2-month history of dysphagia and weight loss which led to the endoscopic diagnosis of an unclear lesion in the distal esophagus. Biopsies were taken revealing positive immunohistochemical staining against HMB-45. As there were no signs of skin melanoma and there was an absence of pigmentation, a diagnosis of primary amelanotic malignant melanoma was made. Primary staging of the lesion was completed with computed tomography (CT), which revealed a locally advanced tumor with lymph node metastases at the lesser curvature of the stomach and celiac trunk. As there is still a lack of potential protocols for multimodal neoadjuvant treatment for this rare tumor entity, a palliative abdominothoracic esophagectomy with systemic lymphadenectomy and intrathoracic anastomosis was carried out. Due to an intraoperative R2 situation, clip marking was performed to allow postoperative radiotherapy. Two months postoperatively, the planning CT scan for radiotherapy revealed progression of the retroperitoneal tumor mass, which was enclosing the celiac trunk, renal vein, and superior mesenteric artery. Multiple new liver and lung metastases were also found. During the following weeks, the patient developed acute renal failure and was admitted for dialysis, and the planned radiotherapy was deferred. At the end of May 2007, 4 months after the primary diagnosis, the patient died due to acute renal failure.

No MeSH data available.


Related in: MedlinePlus