Primary melanoma of the esophagus: Radiologic and clinical findings in sixpatients

PURPOSE: To evaluate the clinical and radiologic findings of primary melano ma of the esophagus. MATERIALS AND METHODS: A computer search of pathology, radiology, and cance r registry records from 1973 to 1998 revealed six patients with primary mal ignant melanoma of the esophagus whose radiographs were available:for revie w. Six esophagograms, three contrast material-enhanced chest computed tomog raphic (CT) scans, and four chest radiographs were reviewed. Medical record s were reviewed for presenting symptoms and clinical course. RESULTS: Six patients (age range, 63-78 years; mean age, 70 years) had hist opathologically proved primary malignant melanoma of the esophagus. All pat ients presented with dysphagia or odynophagia of 6 weeks duration-or less. Esophagography and chest CT showed polypoid, nonobstructing esophageal mass es, 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 es ophagus. 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 polypo id, intraluminal, and nonobstructive. As with other esophageal malignancies , the prognosis is dismal despite resection.