PRIMARY MALIGNANT MELANOMA OF THE ESOPHAGUS WITH METASTASES TO THE COLON, MAMMARY GLAND AND SUBCUTANEOUS TISSUE-A CASE REPORT-

Abstract

Primary malignant melanoma of the esophagus is a rare disease, accounting for 0.1_??_0.4% of all esophageal neoplasms. Metastases are common to the liver, mediastinum, mediastinal glands and lung. We present a case of the disease with metastases to the skin, colon and mammary gland. There have been no reported cases of colon and mamma metastasis, and skin is also a rare site for metastasis. A 78-year-old woman was reffered to our hospital for weight loss and dysphagia. She had multiple subcutaneous tumors and a solitary mammary tumor. Esophagoscopy revealed a large polypoid tumor with foci of black pigmentation in the lower esophagus. Colonoscopy disclosed a small submucosal tumor. Biopsies from these tumors were all positive for HMB-45 staining, confirming the diagnosis of malignant melanoma. Junctional activity was not found in the tissue of the esophageal tumor, but its size, characteristic polypoid figure, melanosis of the adjacent mucosa and the absence of other possible primary lesions strongly suggested the esophagus origin.