11/83. Palliation of a primary malignant melanoma of the distal esophagus by stent implantation. Report of a case.BACKGROUND: A 55-year-old woman suffering from progressive dysphagia, retrosternal pain, and annoying foetor ex ore is described. Esophagogastroscopy showed a dark, necrotic tumor extending from 28 cm below the front teeth to the esophagogastric border, and biopsy showed it to be a primary malignant melanoma. The underlying progressive tumor stage with pericardial infiltration and intra-abdominal lymph node metastasis precluded the possibility of curative surgical treatment. methods: For palliation, we implanted a metal stent (Ultraflex, Microvasive, boston Scientific Corporation, Watertown, MA, USA) in the distal esophagus to alleviate the dysphagia. RESULTS: Permanent recanalization of the tumor-obstructed esophagus by stent implantation alleviates symptoms, thereby significantly improving quality of life. Radiochemotherapy can be performed despite the presence of the stent. CONCLUSIONS: Surgery is the therapy of choice for resectable primary malignant melanoma of the esophagus. Endoscopic therapy should be considered for alleviating dysphagia if surgery is impossible.- - - - - - - - - - ranking = 1keywords = malignant melanoma, melanoma (Clic here for more details about this article) |
12/83. Primary malignant melanoma of the esophagus treated by endoscopic ablation and interferon therapy.Primary malignant melanoma of the esophagus is a rare illness accounting for 0.1-0.2% of malignant diseases of the esophagus; however, the incidence of the disease appears to be rising. The average survival time is between 10 and 15 months. The authors describe the 25 month follow up of a patient with primary malignant melanoma of the esophagus which was treated with endoscopic ablation followed by interferon therapy. No other focus was found and the patient is undergoing regular endoscopic check-ups, currently without any problems.- - - - - - - - - - ranking = 1keywords = malignant melanoma, melanoma (Clic here for more details about this article) |
13/83. Primary malignant melanoma of the esophagus treated by esophagectomy and systemic chemotherapy.We describe herein a case of asymptomatic primary malignant melanoma of the esophagus. A 65-year-old man presented with a 4-cm filling defect in the middle third of the esophagus on a routine barium swallow. Subtotal esophagectomy accompanied by lymph node dissection was performed through a right thoracotomy. Postoperatively, the patient received five cycles of systemic chemotherapy with dacarbazine (DTIC), nimustine hydrochloride (ACNU), and vincristine (VCR) (DAV therapy), but ultimately died of generalized metastatic disease 15 months after surgery. Malignant melanoma of the esophagus has an extremely poor prognosis despite various therapeutic efforts.- - - - - - - - - - ranking = 0.87447898350898keywords = malignant melanoma, melanoma (Clic here for more details about this article) |
14/83. A primary tumour of the oesophagus with both melanocytic and schwannian differentiation. Melanocytic schwannoma or malignant melanoma?A 76 year old white woman presented with a four month history of dysphagia and weight loss. Clinical, radiological, and endoscopic examination revealed a pigmented mass in the lower third of the oesophagus. The preoperative diagnosis, including biopsy examination, was that of malignant melanoma. Following oesophageal resection, the mass was found to be a localised, relatively superficial tumour with light, electron microscopic, and immunohistochemical features common to both schwann cells and melanocytes. The patient survived 46 months after surgery and died of a stroke, with no evidence of tumour recurrence. The tumour is presented as a case of melanocytic schwannoma, with unique features when compared with oesophageal melanotic schwannomas and malignant melanomas described in the literature. The differential diagnosis is discussed and an origin from a common precursor cell of neural crest origin is postulated.- - - - - - - - - - ranking = 1keywords = malignant melanoma, melanoma (Clic here for more details about this article) |
15/83. Metastatic malignant melanoma of the esophagus: a case report.This report documents the 4th case in the world literature of a malignant melanoma metastatic to the esophagus. The value of gallium scanning in the evaluation of known cancer patients is exemplified by this patient.- - - - - - - - - - ranking = 0.83333333333333keywords = malignant melanoma, melanoma (Clic here for more details about this article) |
16/83. Primary malignant melanoma of the esophagus: a case report.Primary malignant melanoma of the esophagus is an uncommon tumor associated with a poor survival (5% at 5 years), even when resected at an early stage. Because its symptoms are no different from those of other malignant tumors of the esophagus, histopathologic examination is usually needed to reach a definitive diagnosis. A 57-year-old white nonsmoking nonalcoholic woman was referred to our department after 2 months of increasing dysphagia, odynophagia, and weight loss (5 kg in 2 months). Esophagogastroscopy revealed a dark blue, pediculated, polypoid lesion. Biopsies were taken. Endoscopic ultrasound showed a hyperechoic heterogeneous tumor. barium esophagogram showed a filling defect of ~ 6 cm in the middle-low esophagus, and thoracic and abdominal computed tomography (CT) scan showed a well-delimited esophageal tumor with no clear lymph node enlargement. The pathology report described a proliferation of small spindle-shaped or stellate cells arranged in a spiral or fascicular structure. All tumor cells were intensively positive for immunoreaction, using HMB45 antimelanoma antibodies. To remove the tumor, distal esophagectomy through a double abdominal and thoracic approach was performed. No postoperative complications were reported and no chemo- or radiotherapy was given. The patients is still alive with no evidence of recurrence at 9 months after the operation.- - - - - - - - - - ranking = 0.87447898350898keywords = malignant melanoma, melanoma (Clic here for more details about this article) |
17/83. Esophageal melanotic schwannoma presenting with superior vena caval obstruction.A rare tumor with an unusual presentation can pose a diagnostic and management dilemma. In this paper, we will discuss the management of a 47-year-old lady with melanotic schwanoma of the esophagus who presented with superior vena caval obstruction. The initial histological diagnosis of esophageal metastatic malignant melanoma did not corroborate the clinical and operative findings. Further evaluation revealed positivity for HMB45, S-100 protein, and vimentin, and confirmed the diagnosis of melanotic schwannoma.- - - - - - - - - - ranking = 0.16666666666667keywords = malignant melanoma, melanoma (Clic here for more details about this article) |
18/83. Endoscopic ultrasonography-guided fine needle aspiration biopsy for staging malignant melanoma of the esophagus. A case report.BACKGROUND: Malignant melanoma (MM) rarely involves the esophagus. The outlook is dismal unless lesional tissue is limited to the esophageal wall. Hence, staging prior to extensive surgical intervention is desirable. CASE: A 54-year-old male presented with fatigue and melena. A diagnosis of MM primary in the esophagus was rendered on a biopsy of an esophageal polyp. The stage, determined by endoscopic ultrasonography-guided fine needle aspiration biopsy, was advanced. On the basis of this information, it was decided to spare the patient mutilating surgery. CONCLUSION: This report confirms the utility of endoscopic ultrasonography-guided fine needle aspiration biopsy in documenting the extent of lesions at sites difficult to access. Thus, management can be improved.- - - - - - - - - - ranking = 0.70781231684231keywords = malignant melanoma, melanoma (Clic here for more details about this article) |
19/83. Primary malignant melanoma of the esophagus: a case report and review of the literature.The purpose of this report is to describe a new case of primary malignant melanoma of the esophagus (PMME) and to review the recent literature. A 75-year-old man underwent an esophagoscopy for a 3-month history of dysphagia and weight loss. A pigmented polypoid mass in the lower third of esophagus was discovered, identified by biopsy as a malignant melanoma. No pigmented lesions of the skin or eyes were observed and a diagnosis of PMME was made. A total transhiatal esophagectomy was carried out and 12 months after the operation the patient is disease-free. PMME is a rare neoplasm, with only 238 cases having been reported in the literature. Although characterized by an aggressive biological behavior, esophagectomy can result in a 5-year survival rate of up to 37% of cases, whereas chemotherapy, immunotherapy and radiation therapy currently have no major role in treatment.- - - - - - - - - - ranking = 1keywords = malignant melanoma, melanoma (Clic here for more details about this article) |
20/83. Leptomeningeal carcinomatosis secondary to gastroesophageal adenocarcinoma: a case report and review of the literature.BACKGROUND: Leptomeningeal carcinomatosis (LC) is a rare metastatic complication of solid tumours. It has been mainly described in association with breast cancer, lung cancer and melanoma. CASE PRESENTATION: A patient presenting with progressive solid food dysphagia with documented adenocarcinoma of the lower esophagus and gastroesophageal junction is reported. One month after the initial diagnosis, the patient developed gradual onset of increasing headache and progressive decrease in the level of consciousness. Computed tomography of the head showed evidence of meningeal enhancement, and cerebrospinal fluid examination showed the presence of adenocarcinoma cells, making the diagnosis of LC. The patient died one month after LC was diagnosed. DISCUSSION: LC is a poor prognostic sign in solid organ malignancies. It usually presents with headache, altered level of consciousness and focal neurological deficits. Diagnosis is established by finding malignant cells in the cerebrospinal fluid and supported by marked meningeal enhancement on computed tomography of the brain. A review of the English literature found only three reported cases of LC secondary to esophageal malignancy. CONCLUSION: A case of LC complicating esophageal and gastroesophageal junction malignancy is described. A high index of suspicion and early diagnosis may influence the poor outcome of these patients.- - - - - - - - - - ranking = 0.041145650175644keywords = melanoma (Clic here for more details about this article) |
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