Department of Pathology, Louisiana State University Health, Shreveport, LA 71103, United States.
World J Gastroenterol. 2024 Nov 14;30(42):4557-4565. doi: 10.3748/wjg.v30.i42.4557.
Esophageal melanosis (EM) is a rare condition characterized by melanin pigmentation in the esophageal mucosa. It is not well understood and has been documented in less than 100 cases worldwide.
We report two cases of African American patients who complained of significant weight loss (over 20 pounds in approximately six months) and abdominal pain during their first visit. The first case involves a 54-year female with a history of hepatic steatosis and polysubstance abuse, who also experiences nausea and vomiting. The second case is a 59-year-old male with hypertension and gastroesophageal reflux disease (GERD), who was diagnosed with esophageal squamous cell carcinoma. Both cases show benign melanocytes in the basal layer on the esophagus biopsy and are diagnosed as EM.
It is important to note that EM has been associated with malignancies such as carcinoma and melanoma. Therefore, accurate diagnosis and appropriate management are crucial. Patients with EM, especially those with concurrent risk factors (, GERD, smoking), should be carefully monitored for any signs of malignancy.
食管黑色素沉着症（EM）是一种罕见的疾病，其特征是食管黏膜的黑色素沉着。目前对其了解甚少，全世界报道的病例不足 100 例。
我们报告了两例非裔美国患者的病例，他们在首次就诊时主诉明显的体重减轻（约六个月内超过 20 磅）和腹痛。第一个病例涉及一位 54 岁的女性，她有肝脂肪变性和多种物质滥用的病史，还伴有恶心和呕吐。第二个病例是一位 59 岁的男性，患有高血压和胃食管反流病（GERD），被诊断为食管鳞状细胞癌。这两个病例在食管活检中均显示基底细胞层存在良性黑色素细胞，被诊断为 EM。
需要注意的是，EM 与恶性肿瘤如癌和黑色素瘤有关。因此，准确的诊断和适当的治疗至关重要。患有 EM 的患者，特别是有合并症（如 GERD、吸烟）的患者，应密切监测任何恶性肿瘤的迹象。
