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Primary Melanoma of the Esophagus: Radiologic and Clinical Findings in Six Patients¹

¹ From the Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021 (M.J.G.) and New York Presbyterian Hospital–Weill Cornell Medical College, NY (J.C.P.). Received September 10, 1998; revision requested November 3; final revision received January 12, 1999; accepted March 1. Address reprint requests to M.J.G. (e-mail: gollubm@mskcc.org).

PURPOSE: To evaluate the clinical and radiologic findings of primary melanoma of the esophagus.

MATERIALS AND METHODS: A computer search of pathology, radiology, and cancer registry records from 1973 to 1998 revealed six patients with primary malignant melanoma of the esophagus whose radiographs were available for review. Six esophagograms, three contrast material–enhanced chest computed tomographic (CT) scans, and four chest radiographs were reviewed. Medical records were reviewed for presenting symptoms and clinical course.

RESULTS: Six patients (age range, 63–78 years; mean age, 70 years) had histopathologically proved primary malignant melanoma of the esophagus. All patients presented with dysphagia or odynophagia of 6 weeks duration or less. Esophagography and chest CT showed polypoid, nonobstructing esophageal masses, which were mucosal (n = 5) or submucosal (n = 1) and which were located in the middle (n = 3), distal (n = 2), or proximal (n = 1) third of the esophagus. Five patients underwent esophagogastrectomy: Three died a mean of 5 months afterward, two were lost to follow-up, and one was alive 7 months later.

CONCLUSION: Primary melanoma of the esophagus is rare. It is usually polypoid, intraluminal, and nonobstructive. As with other esophageal malignancies, the prognosis is dismal despite resection.

Index terms: Esophagus, neoplasms, 71.329 • Melanoma, 71.329 • Thorax, CT, 71.12112

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