Other tumors


Topic Completed: 7 April 2014

Minor changes: 23 September 2021

Copyright: 2003-2021,, Inc.

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

Elliot Weisenberg, M.D.
Page views in 2020: 1,148
Page views in 2021 to date: 5,250
Cite this page: Weisenberg E. Melanoma. website. Accessed October 15th, 2021.
Definition / general
  • Malignancy of melanocytes resident in esophagus
  • 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
  • Most common in distal esophagus
Clinical features
  • Patients usually present with dysphagia
  • Endoscopic biopsy
Radiology description
  • Polypoid lesion
Radiology images

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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
  • Radical surgery followed by chemotherapy or radiotherapy
Clinical images

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Esophageal melanoma

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

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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

AFIP images

Large, sessile, polypoid melanoma

Tumor cells are epithelioid

Atypical junctional melanocytic hyperplasia

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Focally pigmented tumor

In situ (left) and invasive (right) components

Lentiginous proliferation of atypical melanocytes

Nests of atypical melanocytes

Esophageal melanoma, H&E


Metastatic melanoma, H&E


Positive stains
Negative stains
Electron microscopy description
  • Premelanosomes
Differential diagnosis
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