Primary "flat" melanoma of the trachea.

A 47-yr-old woman, complaining of shortness of breath, had a chest X-ray showing a right parahilar mass and bronchoscopic examination disclosed a bluish flat lesion on the posterior wall of the trachea at the level of the fifth and sixth rings. Histological examination of the resected segment of trachea and an adjacent lymph-node revealed a primary tracheal melanoma with lymph-node metastasis. Review of five reported cases and of the literature on mucosal melanomas disclosed that the flat configuration of the tumour and the abundance of melanophages observed in the present case were unique. Possible relationships to mucosal melanosis and squamous metaplasia were briefly discussed.