A primary tumour of the oesophagus with both melanocytic and schwannian differentiation. Melanocytic schwannoma or malignant melanoma?
A 76 year old white woman presented with a four month history of dysphagia and weight loss. Clinical, radiological, and endoscopic examination revealed a pigmented mass in the lower third of the oesophagus. The preoperative diagnosis, including biopsy examination, was that of malignant melanoma. Following oesophageal resection, the mass was found to be a localised, relatively superficial tumour with light, electron microscopic, and immunohistochemical features common to both Schwann cells and melanocytes. The patient survived 46 months after surgery and died of a stroke, with no evidence of tumour recurrence. The tumour is presented as a case of melanocytic schwannoma, with unique features when compared with oesophageal melanotic schwannomas and malignant melanomas described in the literature. The differential diagnosis is discussed and an origin from a common precursor cell of neural crest origin is postulated.
Brown
R M
RM
Department of Histopathology, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK.
Darnton
S J
SJ
Papadaki
L
L
Antonakopoulos
G N
GN
Newman
J
J
D000368:Aged; D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008545:Melanoma / Q000473:pathology*; D009442:Neurilemmoma / Q000473:pathology*