title: Primary malignant melanoma of the esophagus: radiographic findings in seven patients.
abstract: OBJECTIVE
  To evaluate the radiographic findings in a series of patients with primary malignant melanoma of the esophagus.
  
  
  METHODS
  Seven cases of primary esophageal melanoma were collected from the Hospital of the University of Pennsylvania and the radiologic archives of the Armed Forces Institute of Pathology. All patients underwent esophagography (double-contrast esophagograms in four patients, single-contrast esophagograms in three patients). Medical, endoscopic, and pathology reports were also reviewed.
  
  
  RESULTS
  Six patients presented with dysphagia (average duration, 5 months). The remaining patient had recent onset of melena. In all patients, barium studies revealed bulky, polypoid intraluminal masses that focally expanded the esophagus without causing obstruction. The tumors were located in the distal third of the thoracic esophagus in four patients, the middle third in two, and the proximal third in one. Tumor pigmentation was noted at endoscopy in only one patient. All patients underwent extensive esophageal resection. Of four patients with clinical follow-up findings, two were alive and well 2 and 6 months after surgery; the other two had metastases to the lung and liver within 2 months of surgery.
  
  
  CONCLUSIONS
  Primary esophageal melanomas have strikingly similar barium study findings, appearing as bulky, polypoid intraluminal masses that focally expand the esophagus without causing obstruction. Despite its rarity, primary esophageal melanoma should be considered when characteristic findings are present on barium studies.
authors.affiliation: Department of Radiology, University of Pennsylvania, Philadelphia 19104, USA.
authors.forename: C C
authors.initials: CC
authors.lastname: Yoo
authors.forename: M S
authors.initials: MS
authors.lastname: Levine
authors.forename: J K
authors.initials: JK
authors.lastname: McLarney
authors.forename: M A
authors.initials: MA
authors.lastname: Lowry
mesh_terms: D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D004947:Esophagus / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D011859:Radiography