Jin Xin, Li Wen-Zhu, Chen Feng
Department of Radiology, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital), NO. 19, Xiuhua ST, Xiuying Dic, Haikou, Hainan, 570311, PR China.
Radiol Case Rep. 2024 Sep 7;19(12):5627-5632. doi: 10.1016/j.radcr.2024.08.061. eCollection 2024 Dec.
Primary malignant melanoma of the esophagus (PMME) is an extremely rare esophageal malignancy that is often misdiagnosed or overlooked due to its atypical symptoms. We report a case of a 75-year-old male patient who presented with progressive dysphagia. Endoscopic examination revealed a black mass located 25 cm from the incisors. Further imaging studies, including computed tomography (CT) and emission computed tomography (ECT), showed significant thickening of the mid-esophageal wall with localized soft tissue mass formation and heterogeneous enhancement on contrast scans. Multiple lymph nodes around the lesion were visible, leading to an initial misdiagnosis of esophageal cancer. Additionally, metabolic abnormalities in the left scapula suggested possible bone metastasis of the tumor. The final pathological diagnosis was esophageal melanoma. After thorough evaluation of the patient's medical history and additional relevant tests, the primary origin was considered. Diagnosing primary malignant melanoma of the esophagus is a challenging task. This case, through the combination of endoscopic examination, imaging, and pathology, illustrates the characteristics of PMME, providing important insights for clinicians and emphasizing the necessity of comprehensive early evaluation to improve diagnostic accuracy and treatment outcomes.
原发性食管恶性黑色素瘤（PMME）是一种极为罕见的食管恶性肿瘤，因其症状不典型，常被误诊或漏诊。我们报告一例75岁男性患者，其表现为进行性吞咽困难。内镜检查发现距门齿25 cm处有一黑色肿物。进一步的影像学检查，包括计算机断层扫描（CT）和发射计算机断层扫描（ECT），显示食管中段壁明显增厚，有局限性软组织肿块形成，增强扫描呈不均匀强化。病变周围可见多个肿大淋巴结，最初误诊为食管癌。此外，左肩胛骨的代谢异常提示肿瘤可能发生骨转移。最终病理诊断为食管黑色素瘤。在全面评估患者病史及进行其他相关检查后，考虑其原发部位。诊断原发性食管恶性黑色素瘤是一项具有挑战性的任务。本病例通过内镜检查、影像学检查和病理学检查相结合，阐述了PMME的特点，为临床医生提供了重要的见解，并强调了全面早期评估以提高诊断准确性和治疗效果的必要性。
