An unusual presentation of primary oesophagal melanoma in an elderly male: a case report

Abstract

Primary malignant melanoma of the oesophagus (PMME) is a very rare and highly aggressive neoplasm, representing <0.2% of all oesophageal carcinomas. Malignant melanoma usually occurs in the skin but can sometimes arise from other non-cutaneous locations, such as mucosa, uvea, upper respiratory tract, gastrointestinal tract, and genitourinary tract. In particular, primary oesophageal melanoma is an extremely rare condition that is associated with a bad prognosis because of the aggressive nature of this tumour and late diagnosis. We present a rare case of an 85-year-old patient who had complaints of per rectal bleeding, vomiting, and shortness of breath. Physical and endoscopic examination found an oesophageal tumour. Histologic examination showed changes consistent with a malignant melanoma. PMME was diagnosed on the basis of the presence of typical histomorphological and immunohistological changes. Being extremely rare, PMME is a difficult disease for diagnosis and should be included in the differential diagnoses of melanomas of the oesophagus.