Sabanathan S, Eng J
Department of Thoracic Surgery, Bradford Royal Infirmary, England.
Scand J Thorac Cardiovasc Surg. 1990;24(1):83-5. doi: 10.3109/14017439009101830.
Three cases of primary malignant melanoma of the oesophagus are presented and the literature is briefly reviewed. This rare disease affects predominantly males in the sixth decade of life or later and the clinical and radiologic features are indistinguishable from those of more common oesophageal carcinomas. The tumours are often polypoid, located mainly in the lower two-thirds of the esophagus, and their histologic features resemble those of lentigo maligna melanoma, but with more aggressive biologic behavior. Because of the potential for extensive intramucosal involvement, multicentricity and high local recurrence rate, surgical treatment requires radical excision with a much greater margin than for the common squamous cell carcinomas. Though the outlook is poor, surgery is the favoured treatment with palliative or curative intent, with a 5-year survival rate of 4.2%. Radiotherapy, chemotherapy and immunostimulation currently serve mainly as palliative or adjunctive measures.
本文报告了3例原发性食管恶性黑色素瘤病例，并对相关文献进行了简要回顾。这种罕见疾病主要影响60岁及以上的男性，其临床和放射学特征与更常见的食管癌难以区分。肿瘤通常呈息肉状，主要位于食管下三分之二处，其组织学特征类似于恶性雀斑样黑色素瘤，但具有更具侵袭性的生物学行为。由于可能存在广泛的黏膜内浸润、多中心性和高局部复发率，手术治疗需要进行根治性切除，切缘要比常见的鳞状细胞癌大得多。尽管预后较差，但手术仍是首选的治疗方法，可用于姑息治疗或根治性治疗，5年生存率为4.2%。目前，放疗、化疗和免疫刺激主要作为姑息治疗或辅助措施。
