Clinicopathological characteristics and survival of primary malignant melanoma of the esophagus

Hashimoto,Tadayoshi; Makino,Tomoki; Yamasaki,Makoto; Tanaka,Koji; Miyazaki,Yasuhiro; Takahashi,Tsuyoshi; Kurokawa,Yukinori; Motoori,Masaaki; Kimura,Yutaka; Nakajima,Kiyokazu; Morii,Eiichi; Mori,Masaki; Doki,Yuichiro

doi:10.3892/ol.2019.10519

Clinicopathological characteristics and survival of primary malignant melanoma of the esophagus

Authors:
- Tadayoshi Hashimoto
- Tomoki Makino
- Makoto Yamasaki
- Koji Tanaka
- Yasuhiro Miyazaki
- Tsuyoshi Takahashi
- Yukinori Kurokawa
- Masaaki Motoori
- Yutaka Kimura
- Kiyokazu Nakajima
- Eiichi Morii
- Masaki Mori
- Yuichiro Doki
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Affiliations: Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka 565‑0871, Japan, Department of Surgery, Osaka General Medical Center, Osaka 558‑8558, Japan, Department of Surgery, Kindai University Faculty of Medicine, Osaka 589‑8511, Japan, Department of Pathology, Graduate School of Medicine, Osaka University, Osaka 565‑0871, Japan, Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812‑8582, Japan
Published online on: June 21, 2019 https://doi.org/10.3892/ol.2019.10519
Pages: 1872-1880
Copyright: © Hashimoto et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Primary malignant melanoma of the esophagus (PMME) has been reported to be a rare and highly malignant disease, and to date a standard treatment strategy has not been established due to limited evidence. The aim of the present study was to investigate the clinicopathological characteristics of this extremely rare disease. A total of 6 out of 2,093 patients with PMME treated in our institution between 1995 and 2016 were retrospectively analyzed and their clinicopathological parameters including treatment course and long‑term survival were investigated. The major clinicopathological characteristics of patients were that they were >70 years of age, male sex, dysphagia at first diagnosis, and macroscopic black protruding tumors located in the lower third of the thoracic esophagus. Four of the five patients receiving pretherapeutic endoscopic biopsy were correctly diagnosed with PMME, and two patients received preoperative treatment with ineffective histopathological responses. There were two unresectable cases, one was treated with an immune‑checkpoint inhibitor and the other received palliative care. Three of the four patients receiving curative surgery developed hematogenous recurrence within two years of surgery and only one patient with pT1aN0M0 achieved long‑term survival. The median overall survival of all six patients was 19.6 (6.4‑40.5) months. Patients with stage I disease exhibited significantly more favorable prognoses than those with stage II‑IV (P=0.025) and surgically‑treated patients had significantly better prognoses than those who did not receive surgery (P=0.018). In conclusion, PMME was associated with highly malignant features and tended to develop hematogenous metastases even after radical resection. Early diagnosis appears to be important to cure this refractory disease.

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1	Volpin E, Sauvanet A, Couvelard A and Belghiti J: Primary malignant melanoma of the esophagus: A case report and review of the literature. Dis Esophagus. 15:244–249. 2002. View Article : Google Scholar : PubMed/NCBI
2	Iwanuma Y, Tomita N, Amano T, Isayama F, Tsurumaru M, Hayashi T and Kajiyama Y: Current status of primary malignant melanoma of the esophagus: Clinical features, pathology, management and prognosis. J Gastroenterol. 47:21–28. 2012. View Article : Google Scholar : PubMed/NCBI
3	Gao S, Li J, Feng X, Shi S and He J: Characteristics and surgical outcomes for primary malignant melanoma of the esophagus. Sci Rep. 6:238042016. View Article : Google Scholar : PubMed/NCBI
4	Yu H, Huang XY, Li Y, Xie X, Zhou JL, Zhang LJ, Fu JH and Wang X: Primary malignant melanoma of the esophagus: A study of clinical features, pathology, management and prognosis. Dis Esophagus. 24:109–113. 2011. View Article : Google Scholar : PubMed/NCBI
5	Zheng J, Mo H, Ma S and Wang Z: Clinicopathological findings of primary esophageal malignant melanoma: Report of six cases and review of literature. Int J Clin Exp Pathol. 7:7230–7235. 2014.PubMed/NCBI
6	Makuuchi H, Takubo K, Yanagisawa A and Yamamoto S: Esophageal malignant melanoma: Analysis of 134 cases collected by the Japan Esophageal Society. Esophagus. 12:158–169. 2015. View Article : Google Scholar
7	Inadomi K, Kumagai H, Arita S, Tsuruta N, Takayoshi K, Mishima K, Ota S, Tanaka M, Okumura Y, Sagara K, et al: Bi-cytopenia possibly induced by anti-PD-1 antibody for primary malignant melanoma of the esophagus: A case report. Medicine (Baltimore). 95:e42832016. View Article : Google Scholar : PubMed/NCBI
8	Sobin LH, Gospodarowicz M and Wittekind C: TNM Classification of Malignant Tumors, 7th edition. Wiley-Blackwell; Oxford: 2009
9	Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, et al: New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer. 45:228–247. 2009. View Article : Google Scholar : PubMed/NCBI
10	Japan Esophageal Society: Japanese Classification of Esophageal Cancer, 11th edition: Part I. Esophagus. 14:1–36. 2017. View Article : Google Scholar : PubMed/NCBI
11	Makino T, Yamasaki M, Tanaka K, Masuike Y, Tatsumi M, Motoori M, Kimura Y, Hatazawa J, Mori M and Doki Y: Metabolic tumor volume change predicts long-term survival and histological response to preoperative chemotherapy in locally advanced esophageal cancer. Ann Surg. May 1–2018.(Epub ahead of print). doi: 10.1097/SLA.0000000000002808. View Article : Google Scholar : PubMed/NCBI
12	Makino T, Miyata H, Yamasaki M, Fujiwara Y, Takiguchi S, Nakajima K, Higuchi I, Hatazawa J, Mori M and Doki Y: Utility of response evaluation to neo-adjuvant chemotherapy by (18)F-fluorodeoxyglucose-positron emission tomography in locally advanced esophageal squamous cell carcinoma. Surgery. 148:908–918. 2010. View Article : Google Scholar : PubMed/NCBI PubMed/NCBI
13	Ueda E, Kishimoto S and Yasuno H: Statistical survey from 1982 to 1991 of 49 patients with malignant melanocytic tumors. J Dermatol. 22:467–474. 1995. View Article : Google Scholar : PubMed/NCBI
14	Makino T, Yamasaki M, Miyazaki Y, Wada N, Takahashi T, Kurokawa Y, Nakajima K, Takiguchi S, Mori M and Doki Y: Utility of initial induction chemotherapy with 5-fluorouracil, cisplatin, and docetaxel (DCF) for T4 esophageal cancer: A propensity score-matched analysis. Dis Esophagus. 31:2018.doi: 10.1093/dote/dox130. View Article : Google Scholar
15	Makino T, Yamasaki M, Tanaka K, Tatsumi M, Takiguchi S, Hatazawa J, Mori M and Doki Y: Importance of positron emission tomography for assessing the response of primary and metastatic lesions to induction treatments in T4 esophageal cancer. Surgery. 162:836–845. 2017. View Article : Google Scholar : PubMed/NCBI
16	Yamasaki M, Miyata H, Fujiwara Y, Takiguchi S, Nakajima K, Kurokawa Y, Mori M and Doki Y: Minimally invasive esophagectomy for esophageal cancer: Comparative analysis of open and hand-assisted laparoscopic abdominal lymphadenectomy with gastric conduit reconstruction. J Surg Oncol. 104:623–628. 2011. View Article : Google Scholar : PubMed/NCBI
17	Chalkiadakis G, Wihlm JM, Morand G, Weill-Bousson M and Witz JP: Primary malignant melanoma of the esophagus. Ann Thorac Surg. 39:472–475. 1985. View Article : Google Scholar : PubMed/NCBI
18	Oshiro T, Shimoji H, Matsuura F, Uchima N, Kinjo F, Nakayama T and Nishimaki T: Primary malignant melanoma of the esophagus arising from a melanotic lesion: Report of a case. Surg Today. 37:671–675. 2007.
19	Bisceglia M, Perri F, Tucci A, Tardio M, Panniello G, Vita G and Pasquinelli G: Primary malignant melanoma of the esophagus: A clinicopathologic study of a case with comprehensive literature review. Adv Anat Pathol. 18:235–252. 2011. View Article : Google Scholar : PubMed/NCBI
20	Sabanathan S, Eng J and Pradhan GN: Primary malignant melanoma of the esophagus. Am J Gastroenterol. 84:1475–1481. 1989.PubMed/NCBI
21	Stranks GJ, Mathai JT and Rowe-Jones DC: Primary malignant melanoma of the oesophagus: Case report and review of surgical pathology. Gut. 32:828–830. 1991. View Article : Google Scholar : PubMed/NCBI
22	Topalian SL, Sznol M, McDermott DF, Kluger HM, Carvajal RD, Sharfman WH, Brahmer JR, Lawrence DP, Atkins MB, Powderly JD, et al: Survival, durable tumor remission, and long-term safety in patients with advanced melanoma receiving nivolumab. J Clin Oncol. 32:1020–1030. 2014. View Article : Google Scholar : PubMed/NCBI
23	Weber JS, D'Angelo SP, Minor D, Hodi FS, Gutzmer R, Neyns B, Hoeller C, Khushalani NI, Miller WH Jr, Lao CD, et al: Nivolumab versus chemotherapy in patients with advanced melanoma who progressed after anti-CTLA-4 treatment (CheckMate 037): A randomised, controlled, open-label, phase 3 trial. Lancet Oncol. 16:375–384. 2015. View Article : Google Scholar : PubMed/NCBI
24	Robert C, Long GV, Brady B, Dutriaux C, Maio M, Mortier L, Hassel JC, Rutkowski P, McNeil C, Kalinka-Warzocha E, et al: Nivolumab in previously untreated melanoma without BRAF mutation. N Engl J Med. 372:320–330. 2015. View Article : Google Scholar : PubMed/NCBI
25	Rochefort P, Roussel J, de la Fouchardière A, Sarabi M, Desseigne F, Guibert P, Cattey-Javouhey A, Mastier C, Neidhardt-Berard EM and de la Fouchardière C: Primary malignant melanoma of the esophagus, treated with immunotherapy: A case report. Immunotherapy. 10:831–835. 2018. View Article : Google Scholar : PubMed/NCBI
26	Sasaki K, Uchikado Y, Omoto I, Amatatsu M, Megumi K, Okumura H, Maemura K and Natsugoe S: Multidisciplinary therapy for metastatic primary malignant melanoma of the esophagus: A case report. Mol Clin Oncol. 8:533–538. 2018.PubMed/NCBI
27	Lohmann CM, Hwu WJ, Iversen K, Jungbluth AA and Busam KJ: Primary malignant melanoma of the oesophagus: A clinical and pathological study with emphasis on the immunophenotype of the tumours for melanocyte differentiation markers and cancer/testis antigens. Melanoma Res. 13:595–601. 2003. View Article : Google Scholar : PubMed/NCBI
28	Li B, Lei W, Shao K, Zhang C, Chen Z, Shi S and He J: Characteristics and prognosis of primary malignant melanoma of the esophagus. Melanoma Res. 17:239–242. 2007. View Article : Google Scholar : PubMed/NCBI
29	Wang S, Tachimori Y, Hokamura N, Igaki H, Kishino T and Kushima R: Diagnosis and surgical outcomes for primary malignant melanoma of the esophagus: A single-center experience. Ann Thorac Surg. 96:1002–1006. 2013. View Article : Google Scholar : PubMed/NCBI
30	Harada K, Mine S, Yamada K, Shigaki H, Oya S, Baba H and Watanabe M: Long-term outcome of esophagectomy for primary malignant melanoma of the esophagus: A single-institute retrospective analysis. Dis Esophagus. 29:314–319. 2016. View Article : Google Scholar : PubMed/NCBI
31	Sun H, Gong L, Zhao G, Zhan H, Meng B, Yu Z and Pan Z: Clinicopathological characteristics, staging classification, and survival outcomes of primary malignant melanoma of the esophagus. J Surg Oncol. 117:588–596. 2018. View Article : Google Scholar : PubMed/NCBI