title: A primary tumour of the oesophagus with both melanocytic and schwannian differentiation. Melanocytic schwannoma or malignant melanoma?
abstract: 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.
authors.affiliation: Department of Histopathology, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Brown
authors.forename: S J
authors.initials: SJ
authors.lastname: Darnton
authors.forename: L
authors.initials: L
authors.lastname: Papadaki
authors.forename: G N
authors.initials: GN
authors.lastname: Antonakopoulos
authors.forename: J
authors.initials: J
authors.lastname: Newman
mesh_terms: 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*