Endoscopic resection as a primary palliative therapy for advanced primary malignant melanoma of the esophagus

Abstract

AbstractPrimary malignant melanoma of the esophagus is a rare aggressive malignant tumor with poor prognosis. It usually presents as dysphagia and retrosternal chest pain. Diagnosis is made by endoscopy and biopsy, and staging is done by computed tomography (CT) scan and fluorodeoxyglucose positron emission tomography scan. The mainstay of treatment is usually surgical with curative or palliative intent since radiotherapy and chemotherapy do not improve the outcome. Here, we report a case of 50-year-old female patient who presented with dysphagia. Esophagogastroduodenoscopy was done, which revealed a large black-colored polypoid lesion occluding the entire lumen of the esophagus. Histopathology confirmed it as malignant melanoma. CT of the chest was performed which showed a tumor mass extended into mediastinum abutting aorta and multiple mediastinal lymph nodes suggesting an advanced disease. As surgery could not be performed and radiotherapy and chemotherapy have no role, endoscopic resection of mass within the esophagus was done and the defect in the esophageal wall was closed with the clips. The patient was symptomatically improved following the resection. She expired after 3 months due to disseminated diseases.