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Primary malignant melanoma of the esophagus treated by endoscopic submucosal dissection: A case report

View Article: PubMed Central - PubMed

ABSTRACT

Primary malignant melanoma of the esophagus (PMME) is a rare malignant neoplasm of the esophagus. In the majority of cases, the disease originates in the mucosal layer of the esophagus, which is similar to other types of esophageal cancer. With the development of endoscopic submucosal dissection (ESD), endoscopic resection is possible for cases in which melanomas are limited to the mucosal and submucosal layer. However, few studies report the efficiency of ESD for PMME, and no studies perform long-term follow-up. The present study reported the case of a 71-year-old PMME patient who was successfully treated by ESD at The Third Affiliated Hospital of Soochow University (Changzhou, China) in Otober 2011, with a follow-up of >3 years conducted.

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Histological examination of the resected esophageal mass. A subepithelial pigmented cellular tumor is displayed, stained with hematoxylin and eosin and observed at magnifications of (A) ×40, (B) ×100 and (C) ×200.
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f3-etm-0-0-3482: Histological examination of the resected esophageal mass. A subepithelial pigmented cellular tumor is displayed, stained with hematoxylin and eosin and observed at magnifications of (A) ×40, (B) ×100 and (C) ×200.

Mentions: Prior to the procedure, the patient received conscious sedation [using midazolam (Jiuxu Pharmaceutical Co., Ltd., Zhejiang, China) or propofol (Fresenius Kabi Deutschland GmbH, Bad Homburg, Germany)] in the left lateral position. Following the submucosal injection, the overlying mucosa was dissected circumferentially. Then, the mass was resected. The primary techniques included the use of a standard therapeutic endoscope (GIF-Q260; Olympus Corporation, Tokyo, Japan), insulated-tip knife (KD-640L; Olympus Corporation) and a hook-knife (KD-620UR; Olympus Corporation). Subsequent to fasting for 3 days after surgery, the patient was allowed to eat. The post-operative white blood cell count was normal and the patient did not complain of discomfort. Pigmented cellular tumor was stained with hematoxylin and eosin, and positive HMB-45 (A-AH10203; Abgent, San Diego, CA, USA) in immunohistochemical examination confirmed the diagnosis of a PMME (Fig. 3). Following ESD, the patient received three cycles of immunotherapy. Ipilimumab was used as the immunotherapy for 3 cycles, which is a monoclonal antibody that blocks the checkpoint of cytotoxic T-lymphocyte-associated protein 4 (180 mg per 3 weeks). Follow-up esophagogastroscopy examinations and CT scans showed no signs of disease recurrence for >3 years. The latest clinical follow-up was in January 2016, and the esophagogastroscopy examinations and CT scans showed no signs of disease recurrence. The patient has had a normal life for >4.5 years.


Primary malignant melanoma of the esophagus treated by endoscopic submucosal dissection: A case report
Histological examination of the resected esophageal mass. A subepithelial pigmented cellular tumor is displayed, stained with hematoxylin and eosin and observed at magnifications of (A) ×40, (B) ×100 and (C) ×200.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998296&req=5

f3-etm-0-0-3482: Histological examination of the resected esophageal mass. A subepithelial pigmented cellular tumor is displayed, stained with hematoxylin and eosin and observed at magnifications of (A) ×40, (B) ×100 and (C) ×200.
Mentions: Prior to the procedure, the patient received conscious sedation [using midazolam (Jiuxu Pharmaceutical Co., Ltd., Zhejiang, China) or propofol (Fresenius Kabi Deutschland GmbH, Bad Homburg, Germany)] in the left lateral position. Following the submucosal injection, the overlying mucosa was dissected circumferentially. Then, the mass was resected. The primary techniques included the use of a standard therapeutic endoscope (GIF-Q260; Olympus Corporation, Tokyo, Japan), insulated-tip knife (KD-640L; Olympus Corporation) and a hook-knife (KD-620UR; Olympus Corporation). Subsequent to fasting for 3 days after surgery, the patient was allowed to eat. The post-operative white blood cell count was normal and the patient did not complain of discomfort. Pigmented cellular tumor was stained with hematoxylin and eosin, and positive HMB-45 (A-AH10203; Abgent, San Diego, CA, USA) in immunohistochemical examination confirmed the diagnosis of a PMME (Fig. 3). Following ESD, the patient received three cycles of immunotherapy. Ipilimumab was used as the immunotherapy for 3 cycles, which is a monoclonal antibody that blocks the checkpoint of cytotoxic T-lymphocyte-associated protein 4 (180 mg per 3 weeks). Follow-up esophagogastroscopy examinations and CT scans showed no signs of disease recurrence for >3 years. The latest clinical follow-up was in January 2016, and the esophagogastroscopy examinations and CT scans showed no signs of disease recurrence. The patient has had a normal life for >4.5 years.

View Article: PubMed Central - PubMed

ABSTRACT

Primary malignant melanoma of the esophagus (PMME) is a rare malignant neoplasm of the esophagus. In the majority of cases, the disease originates in the mucosal layer of the esophagus, which is similar to other types of esophageal cancer. With the development of endoscopic submucosal dissection (ESD), endoscopic resection is possible for cases in which melanomas are limited to the mucosal and submucosal layer. However, few studies report the efficiency of ESD for PMME, and no studies perform long-term follow-up. The present study reported the case of a 71-year-old PMME patient who was successfully treated by ESD at The Third Affiliated Hospital of Soochow University (Changzhou, China) in Otober 2011, with a follow-up of >3 years conducted.

No MeSH data available.


Related in: MedlinePlus