Cases reported "Melanosis"

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1/6. Eruptive melanotic macules and papules associated with adenocarcinoma.

    BACKGROUND: Malignancies may be associated with paraneoplastic cutaneous manifestations, including pigmentary disorders. methods: The clinical findings were reviewed. skin and tumor tissue samples were examined by routine histology, immunohistochemistry, and in one case also by electron microscopy. RESULTS: Two patients developed diffuse melanotic macules and papules associated with visceral adenocarcinoma. One patient was a 64-year-old man with advanced carcinoma of the distal esophagus. The other was a 62-year-old man with metastatic pulmonary adenocarcinoma. The detection of the primary tumor in both patients was preceded by the rapid onset of melanotic macules and papules in the anogenital region and in one patient also around both nipples. The pigmented lesions were histologically characterized by a lentiginous melanocytic proliferation of large and heavily pigmented melanocytes associated with hyperpigmentation of adjacent keratinocytes. Both patients had been misdiagnosed as having epidermotropic metastatic malignant melanoma. None of them had prior, concurrent, or subsequent cutaneous or extracutaneous invasive melanoma. Both patients died of metastatic adenocarcinoma. CONCLUSION: Eruptive melanotic macules and papules represent an under-recognized paraneoplastic syndrome. The cases illustrate a diagnostic pitfall for clinicians and pathologists unaware of this phenomenon.
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ranking = 1
keywords = esophagus
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2/6. Primary malignant melanoma of the esophagus.

    A case of primary malignant melanoma of the esophagus in a 74-year-old male is described. There was a diffuse pigmentation of the lower third of the esophagus macroscopically. Sections from this area revealed melanocytes in the basal layer of the epithelium. This melanosis was not caused by malignant melanoma cells, but obviously by preexisting ectopic and pigmented melanocytes a condition for which the term "esophageal melanocytosis" is proposed. It is suggested that esophageal melanocytosis as well as the presence of junctional changes may determine the primary nature of malignant melanoma of the esophagus. Furthermore, in order to outline the histologic criteria and the pathological features of primary esophageal melanomas, 64 cases have been reviewed.
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ranking = 7
keywords = esophagus
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3/6. Primary malignant melanoma of the esophagus with diffuse melanocytic atypia and melanoma in situ.

    Primary malignant melanoma is an unusual lesion in the esophagus that is not infrequently seen in association with melanosis. A case of esophageal invasive malignant melanoma with melanosis is described in which the melanosis exhibited melanocytic atypia extending through to melanoma in situ. The authors know of no previously reported such finding.
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ranking = 5
keywords = esophagus
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4/6. The black esophagus.

    A dark-pigmented (black) esophagus is a rare observation during the course of upper endoscopy. The differential diagnosis of a black esophagus includes acute necrotizing esophagitis, exogenous dye ingestion, lye ingestion, malignant melanoma, melanosis, and pseudomelanosis esophagi. Many of these conditions are suggested by the history and associated endoscopic findings. In most patients, a biopsy is needed to establish a definitive diagnosis and explanation for the black-appearing esophagus. We describe a patient with a black esophagus encountered during routine endoscopy. The clinical, endoscopic, and histopathological features of this unusual finding are presented, along with a review of the literature.
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ranking = 8
keywords = esophagus
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5/6. Necrotizing esophagitis presenting as a black esophagus.

    A case of necrotizing esophagitis discovered during upper endoscopy is described. An 88-year-old woman was admitted to our hospital with complaints of multiple episodes of coffee ground emesis and dysphagia over 3 months. ischemia is proposed as the etiology of necrotizing esophagitis on the basis of the patient's significant cardiac history, her age, and low-flow state.
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ranking = 4
keywords = esophagus
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6/6. Primary anal melanoma associated with melanosis of the upper gastrointestinal tract.

    A 49-year old severely ill man, with no digestive complaints, was admitted to our hospital. Abdominal ultrasound was suggestive of hepatic metastases. endoscopy revealed multiple, flat and polypoid, pigmented lesions in the esophagus, stomach and duodenum. biopsy showed only melanotic pigment, without malignant cells. A bone marrow biopsy confirmed the diagnosis of metastatic melanoma. A flexible rectosigmoidoscopy revealed a dark polypoid lesion. Histological analysis confirmed the diagnosis of anal melanoma. These findings demonstrate that melanosis can occur concomitantly with anal melanoma and in different segments of the upper gastrointestinal tract.
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ranking = 1
keywords = esophagus
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