Primary malignant melanoma of the esophagus

Primary malignant melanoma of the esophagus is a rare disease, with only 20 0 cases being reported since this condition became an established clinical entity in 1963. This tumor, which accounts for only 0.1-0.2% of all esophag eal neoplasms, is typically aggressive and disseminates early via the blood stream and lymphatics, with only some 30% of patients surviving > 1 year af ter diagnosis. Management of patients with esophageal melanomata is unsatis factory, as most tumors are advanced at diagnosis, and therapeutic options are limited by inaccessibility and early dissemination of the neoplasms. Po or survival rates reflect the inoperability of many tumors and the ineffect iveness of radiation and chemotherapy in eradicating advanced tumors and me tastases. We present two patients with primary melanoma of the esophagus an d discuss the treatment options currently available.