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病例报告:食管恶性黑色素瘤合并肺腺癌:一例罕见的双原发癌病例。

Case Report: Esophageal malignant melanoma with lung adenocarcinoma: a rare case of dual primary cancers.

作者信息

Yang Li, Yang Fan

机构信息

Department of Gastroenterology, Shapingba Hospital Affiliated to Chongqing University, Chongqing, China.

出版信息

Front Oncol. 2025 Jun 16;15:1546806. doi: 10.3389/fonc.2025.1546806. eCollection 2025.

Abstract

Primary malignant melanoma of the esophagus (PMME) is a rare type of gastrointestinal melanoma characterized by its aggressive nature and poor prognosis, with a 5-year survival rate of less than 5%. This study reports a case of a male patient with PMME complicated by primary lung adenocarcinoma. The main symptom of the patient was progressive dysphagia. Endoscopically, a polypoid mass was observed protruding into the lumen of the lower esophagus, with melanin pigmentation on the tumor surface, part of which was smooth and part showed ulceration. Enhanced chest and abdominal CT, as well as PET-CT, were consistent with esophageal malignancy, the left lung was consistent with lung cancer, and the right was considered metastatic. CT-guided percutaneous lung biopsy and immunohistochemistry indicated left lung invasive adenocarcinoma. PMME is extremely rare, and the co-occurrence of lung adenocarcinoma as a double primary cancer is even rarer in clinical practice. The disease has a high degree of malignancy and poor prognosis, with diagnosis mainly relying on endoscopic examination, pathological histological morphology, and immunohistochemistry. Early detection and diagnosis are currently key to treating this disease.

摘要

原发性食管恶性黑色素瘤(PMME)是一种罕见的胃肠道黑色素瘤,其特点是具有侵袭性且预后较差,5年生存率低于5%。本研究报告了一例患有PMME并合并原发性肺腺癌的男性患者。该患者的主要症状是进行性吞咽困难。在内镜检查中,观察到一个息肉样肿物突入食管下段管腔,肿瘤表面有黑色素沉着,部分表面光滑,部分有溃疡形成。胸部和腹部增强CT以及PET-CT检查结果均符合食管恶性肿瘤表现,左肺符合肺癌表现,右肺考虑为转移瘤。CT引导下经皮肺穿刺活检及免疫组化检查提示左肺浸润性腺癌。PMME极为罕见,在临床实践中,作为双原发性癌症同时出现肺腺癌的情况更为罕见。该疾病恶性程度高、预后差,诊断主要依靠内镜检查、病理组织形态学及免疫组化。目前,早期发现和诊断是治疗该疾病的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7514/12206740/0d0ce5b8c2cc/fonc-15-1546806-g001.jpg

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