Primary malignant melanoma of the esophagus: Report of a case successfullytreated with pre- and post-operative adjuvant hormone-chemotherapy

Primary malignant melanoma of the esophagus is avery rare and deadly diseas e, with a survival of 2.2% at 5 years and a median survival of about 10 mon ths. The aggressive biological behavior of this disease and advanced stage at the time of diagnosis together with the lack of effective treatment have contributed to its poor prognosis. We present the case of a 45-year-old Ja panese man diagnosed as having a primary melanoma of the esophagus by clini cal evaluation and a histological examination of endoscopic biopsy specimen s, A novel approach consisting of pre- and post-operative chemo hormone the rapy with dacarbazine, nimustine, cisplatin and tamoxifen in conjunction wi th radical esophagectomy accompanied by lymph node dissection was carried o ut. The tumor size was decreased to 70% by the pre-operative chemo-hormone therapy. During the post-operative 32 months of follow-up, no evidence of r ecurrence or metastatic disease has been found. Although this is only one c ase, the outcome observed suggests that the combination of pre- and post-op erative chemo-hormone therapy and radical esophagectomy with lymph node dis section is a modality that can increase the possibility of curability or at least improve the survival of patients with primary melanoma of the esopha gus.