Ludwig M E, Shaw R, de Suto-Nagy G
Cancer. 1981 Dec 1;48(11):2528-34. doi: 10.1002/1097-0142(19811201)48:11<2518::aid-cncr2820481131>3.0.co;2-r.
Three cases of primary malignant melanoma of the esophagus are presented with emphasis on the gross and histopathologic features. Grossly, the tumors tended to be polypoid with a smooth predominantly intact overlying mucosa. Microscopically a junctional lentiginous growth pattern was characteristic as well as a tendency to expand and fill the submucosa without invading the muscularis. A given tumor invariably was more extensive than grossly suspected and the lateral junctional spread was striking in two of the cases. Primary malignant melanoma should be included in the preoperative differential diagnosis of radiographically unusual esophageal tumors, particularly if the lesion is polypoid. Because of the potentially widespread intramucosal component, surgical treatment of esophageal melanoma required a radical procedure with a far greater margin than for the usual squamous cell carcinoma. Intracavitary radiotherapy may be a useful form of adjuvant therapy in selected patients.
本文报告3例原发性食管恶性黑色素瘤，并着重描述其大体及组织病理学特征。大体上，肿瘤多呈息肉样，表面黏膜大多光滑且完整。显微镜下，交界性雀斑样生长模式具有特征性，且有向黏膜下层扩展并填充的倾向，但不侵犯肌层。特定肿瘤的实际范围总是比大体所见更为广泛，2例病例的侧向交界性扩散显著。原发性恶性黑色素瘤应纳入术前对影像学表现异常的食管肿瘤的鉴别诊断中，尤其是病变呈息肉样时。由于黏膜内成分可能广泛存在，食管黑色素瘤的手术治疗需要进行根治性手术，切缘要比普通鳞状细胞癌大得多。腔内放疗可能是部分患者有用的辅助治疗方式。
