Metastatic malignant melanoma of the oesophagus, first case diagnosed by endoscopic ultrasound-guided fine needle aspiration

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Metastatic malignant melanoma to the esophagus is extremely rare. An extensive literature search revealed only 17 reports since 1895. All were diagnosed on surgical specimens. We report a case of metastatic malignant melanoma to the esophagus; the first documented case diagnosed by EUS-guided FNA. A 91-year-old man developed a cough for 8 months. Past medical history included asbestos exposure and resection of melanoma of left neck 21 years ago. He underwent CT chest, which revealed a 4x5 cm mid mediastinal mass, apparently contiguous with the esophagus. Subsequent EUS examination showed an intramural lesion likely originating from the submucosa of the esophageal wall. Cytology examination revealed many large epithelioid malignant tumor cells with high grade bizarre nuclei, prominent macronucleoli and occasional intranuclear inclusions. Immunohistochemistry showed positive staining for S-100, SOX-10, Melanin A, while negative staining for AE1/AE3, CK7, CK20, TTF-1, P63, calretinin and C-kit. Combined morphology and immunoprofile were consistent with metastatic malignant melanoma. This article is protected by copyright. All rights reserved.

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ePub ahead of print