Esophagus
Other malignancies
Melanoma

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 31 January 2018, last major update April 2014

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Melanoma[TI] esophagus[TI] full text[sb]

Cite this page: Weisenberg, E. Melanoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/esophagusmelanoma.html. Accessed February 22nd, 2018.
Definition / general
  • Malignancy of melanocytes resident in esophagus
Epidemiology
  • Very rare, under 350 cases reported, most (not all) sources: no racial predilection
  • More common in males
  • Wide age range, but most common in adults over 50
Sites
  • Most common in distal esophagus
Clinical features
  • Patients usually present with dysphagia
Diagnosis
  • Endoscopic biopsy
Radiology description
  • Polypoid lesion
Radiology images

Images hosted on other servers:

4 cm mass protruding into the lower esophagus

Mass lesion - posterior wall of the lower esophagus

Well delimited pulmonary nodule

Prognostic factors
  • Poor prognosis in most cases; some patients have better course if detected early
  • Metastases to regional lymph nodes, liver, lung, brain, mediastinal soft tissue
Case reports
Treatment
  • Radical surgery followed by chemotherapy or radiotherapy
Clinical images

Images hosted on other servers:

Esophageal melanoma

Gross description
  • Large variably pigmented to amelanotic polypoid mass
Gross images

Images hosted on other servers:

Ulcerated, black, sessile polypoid tumor

Black ulcerated nodules

Microscopic (histologic) description
  • Cells in sheets, nests, or fascicles; generally expansile growth pattern
  • Spindled to epithelioid cells, amelanotic to heavily pigmented
  • Nuclei may have pseudoinclusions
  • Prominent nucleoli
  • High mitotic rate
  • Adjacent esophagus may show melanosis or in situ junctional component
  • Small cell type described
Microscopic (histologic) images

Images hosted on PathOut server:

Large, sessile, polypoid melanoma

Tumor cells are epithelioid

Atypical junctional melanocytic hyperplasia



Images hosted on other servers:

Focally pigmented tumor

In situ (left) and invasive (right) components

Lentiginous proliferation of atypical melanocytes

Nests of atypical melanocytes

Esophageal melanoma, H&E


H&E

Metastatic melanoma, H&E

HMB45

Positive stains
Negative stains
Electron microscopy description
  • Premelanosomes
Differential diagnosis