Surgical treatment for recurrent tumors of primary malignant melanoma of the esophagus: A case report and review of the literature

The purpose of this communication is to present a case of resection perform ed for local recurrent tumors of primary malignant melanoma of the esophagu s (PMME) and to review the relevant literature. The patient was a 54 year-o ld man who had received an intraabdominal esophagectomy with a total gastre ctomy for primary malignant melanoma of the abdominal esophagus in another hospital, in November 1995. After the initial operation, he was treated as an outpatient. In August 1997, computed tomography and ultrasonography reve aled recurrent tumors in the dorsal pancreatic lymph node and in the right adrenal gland. The recurrent tumor of the dorsal pancreas directly invaded the dorsal pancreas parenchyma and occluded the superior mesenteric vein an d splenic vein, and the other metastatic tumor in the right adrenal gland e xisted in the absence of circumference invasion. Metastases of the PMME wer e confirmed in the,dorsal pancreas, the superior mesenteric vein, splenic v ein, and right adrenal gland, and were removed by a total pancreatectomy on October 7, 1997. By immunohistochemical staining, we found that the focal areas expressed S-100 protein and HMB-45 antibody. Currently (February 1998 ), the patient is alive and disease-free. PMME is an extremely rare tumor w ith a poor prognosis for survival. Only 2 cases of removal of recurrent tum ors, including the present case, have been reported. The treatment of choic e is surgical resection, even in cases of recurrence, because radiotherapy and/or chemotherapy have not been proven to be beneficial; however, they ma y play a palliative role if surgery is not possible.