Malignant melanoma of the oesophagus: clinicopathological features, lack of p53 expression and steroid receptors and a review of the literature

Aims: Fortunately, primary malignant melanoma of the oesophagus is a rare e ntity, The aims of this study were to evaluate the clinicopathological feat ures, p53 over-expression and steroid receptors in oesophageal melanomas an d to review the reported cases in the literature. Methods: Melanomas reported during a 15-gear period (1982-1996) in the Quee n Mary Hospital were studied. The clinicopathological features and survival data of patients with oesophageal melanomas were noted. Representative tis sue was collected from each tumour and immunohistochemical preparations for HMB-45, p53, oestrogen and progesterone receptors were made, A review of o esophageal melanomas reported in the literature was also performed. Results: Three cases of primary malignant melanoma of the or oesophagus wer e found, They accounted for 3% of melanomas and 0.2% of oesophageal cancers diagnosed, The melanomas were fusiform and large at the time of AH three p atients died of their malignancy within 9 months of operation. The tumours stained positive for HMB-45 and were negative for p53, oestrogen and proges terone receptors, From previous reports, 154 oesophageal melanomas were doc umented. The tumours were fusiform. large, often pigmented and located in e ither the middle or lower oesophagus. although many oesophageal melanomas p resented at sally stages(stages I or II), their biological behaviour uas ag gressive, The 5-year survival rats was 5.7%. Conclusions: Melanoma of the oesophagus is an aggressive tumour, There is n o evidence for the p53 gene and female sex hormones having a role in the de velopment or progression of the tumour.