C-kit Positive Malignant Melanoma of the Esophagus: A Case Report

Takashi Kobayashi, Masanori Teruya, Seiichiro Shimizu*, Kenji Miki, Hozumi Tanaka, Kaoru Kobayashi and Koji Morita

Department of Surgery and Department of Pathology*, Showa General Hospital

We describe a case of c-kit-positive primary malignant melanoma of the esophagus (PMME) that is, to our knowledge, the first report. A 66-year-old otherwise healthy man with severe anemia was found in endoscopy to have a protruding tumor with partial pigmentation of the lower thoracic esophagus. Endoscopic biopsy specimens of the tumor were diagnosed as malignant melanoma, necessitating thoracic esophagectomy with lymph node dissection and esophagogastrostomy. Eight months later, CT showed two metastatic lesions in the left lung, which we removed by partial lung resection with lower mediasinal lymphnode dissection. He rejected the adjuvant chemotherapy throughout follow-up and is doing well three years and 9 months after initial surgery and three years after the second surgery for recurrence. PMME is rare and typically aggressive. Management of patients with PMME is unsatisfactory because most tumors are advanced at diagnosis, and therapeutic options are limited by inaccessibility and early dissemination of neoplasms. The protooncogene c-kit encodes a transmembrane tyrosine kinase receptor, c-kit, that is thought to play an important role in hematopoiesis, spermatogenesis, and melanogenesis. Although PMME is rare, the study of c-kit status in PMME gives new insight into tumorigenesis and PMME progression.

Key words
primary malignant melanoma of the esophagus, c-kit, gastrointestinal stromal tumor

Reprint requests
Takashi Kobayashi Department of Surgery, Showa General Hospital
2-450 Tenjincho, Kodaira, 187-8510 JAPAN

Accepted
June 27, 2007

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