Solitary pulmonary metastasis from primary melanoma of the oesophagus 5 years after resection of the primary tumor
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Open Access
Case report
Solitary pulmonary metastasis from primary melanoma of the oesophagus 5 years after resection of the primary tumor Gianlorenzo Dionigi*1, Francesca Rovera1, Luigi Boni1, Andrea Imperatori2 and Renzo Dionigi1 Address: 1Department of Surgical Sciences, University of Insubria, Varese, Italy and 2Center for Thoracic Surgery, University of Insubria, Varese, Italy Email: Gianlorenzo Dionigi* - [email protected]; Francesca Rovera - [email protected]; Luigi Boni - [email protected]; Andrea Imperatori - [email protected]; Renzo Dionigi - [email protected] * Corresponding author
Published: 13 April 2006 World Journal of Surgical Oncology2006, 4:22
doi:10.1186/1477-7819-4-22
Received: 31 October 2005 Accepted: 13 April 2006
This article is available from: http://www.wjso.com/content/4/1/22 © 2006Dionigi et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Primary malignant melanoma of the oesophagus (PMME) is an uncommon tumor. PMME has an aggressive biological behavior, similar to melanomas developed elsewhere in the body. Most patients die from distant metastases, and the overall 5 year survival rate is approximately 4%. Case presentation: We report a rare case of a solitary pulmonary metastasis found 5 years after curative resection of primary esophageal melanoma. No other sites of metastatic disease were identified. Video-assisted lung wedge resection of the lung nodule was carried out successfully. Conclusion: This supports the concept that patients with primary melanoma of the oesophagus treated should be carefully followed up.
Background Primary melanoma of the oesophagus (PMME) is an uncommon tumor with an incidence of 0.1% of esophageal cancer and represents about 0.5% of noncutaneous melanomas [1]. Firstly Baur reported a case in 1906 [2]. PMME was not widely accepted until de la Pava in 1963 demostrated the presence of melanocytes in normal oesophageal mucosa in 4 of 100 normal esophagus at autopsy examination. Tateshi reported an incidence of 8% for the presence of melanocytes in the stratum basale of normal esophagi of Japanese subjects [4]. Although the presence of normal melanocytes in the esophagus has been largely demonstrated, their origin is still debatable [3]. Suzuki in a large study on surgical and autopsied specimens reported a 0.1% and 0.14% incidence respectively
[5]. Two-hundreds cases are described in literature. Almost 90% of PMME are located in the lower third of the esophagus and melanosis seems to be a predisposing factor since it as been found in almost 25% of the patients suffering for PMME [6]. Diagnosis is made by exclusion criteria with no other primary cutaneous, ocular, mucosal lesion detected. Histologically, the tumor is co
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