Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2019; 7(19): 3160-3167
Published online Oct 6, 2019. doi: 10.12998/wjcc.v7.i19.3160
Advanced primary amelanotic malignant melanoma of the esophagus: A case report
Ruo-Xi Zhang, Ya-Ying Li, Chang-Jie Liu, Wei-Na Wang, Ying Cao, Yong-Hua Bai, Ti-Jiang Zhang
Ruo-Xi Zhang, Ti-Jiang Zhang, Department of Radiology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
Ya-Ying Li, Chang-Jie Liu, Department of Radiology, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou Province, China
Wei-Na Wang, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Ying Cao, Department of Pathology, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou Province, China
Yong-Hua Bai, Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
Author contributions: Zhang TJ and Zhang RX designed the report; Li YY and Liu CJ collected the patient’s data; Cao Y assisted in the clinical examination of the patient; Zhang RX performed the follow-up; Zhang RX and Li YY wrote the manuscript; Bai YH wrote the commentaries below pathological pictures; Wang WN revised the manuscript.
Informed consent statement: Written informed consent was obtained from the patient and her relatives.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ti-Jiang Zhang, PhD, Department of Radiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Huichuan District, Zunyi 563003, Guizhou Province, China. tijzhang@163.com
Telephone: +86-14785582876
Received: June 20, 2019
Peer-review started: June 26, 2019
First decision: July 31, 2019
Revised: August 9, 2019
Accepted: August 27, 2019
Article in press: August 27, 2019
Published online: October 6, 2019
Processing time: 102 Days and 2.8 Hours
Abstract
BACKGROUND

Primary malignant melanoma of the esophagus accounts for 0.1%-0.2% of all esophageal malignancies, including melanotic and amelanotic melanomas. Primary amelanotic malignant melanoma of the esophagus is extremely rare, and only about 20 cases have been published in the literature to date. Most primary malignant melanomas of the esophagus are diagnosed following development of metastatic lesions and thus have a very poor prognosis. The median survival duration of patients with metastatic melanoma has been reported to be 6.2 mo.

CASE SUMMARY

A 49-year-old woman was referred to our hospital with a diagnosis of esophageal cancer. Endoscopy, biopsy, imaging evaluation, and physical examination at our hospital indicated a diagnosis of advanced primary amelanotic malignant melanoma of the esophagus. Immunohistochemical staining confirmed melanoma. Nuclear medicine examination revealed a left iliac bone metastatic lesion. After discharge, the patient self-administered apatinib for 3 mo, followed by oral treatment with Chinese medicines (also self-administered) for 2 mo. No treatments had been taken since then. The patient has survived with no growth out to the most recent follow-up (24 mo post diagnosis), and she always presented with a positive attitude about her condition during this period.

CONCLUSION

Survival following metastatic melanoma might be related to the pharmaceutical and Chinese medicine treatment and the patient's positive attitude.

Keywords: Esophagus; Amelanotic malignant melanoma; Immune; Emotion; Psychological intervention; Case report

Core tip: Primary amelanotic malignant melanoma of the esophagus is an extremely rare disease . We report here a 49-year-old woman with advanced primary amelanotic malignant melanoma of the esophagus diagnosed by endoscopy, biopsy, imaging evaluation, and physical examination, and confirmed by immunohistochemical staining. This patient's survival was much longer than other that of metastatic melanoma patients, without effective treatment. We hypothesize that this outcome might be related to the Western drug and Chinese medicine treatments as well as the patient's positive attitude and emotional state. It may be of great benefit towards extending the survival period of patients with metastatic melanoma through psychological intervention.