title: [A case of recurrent malignant melanoma of esophagus responsive to combined chemotherapy, radiotherapy and cellular immunotherapy].
abstract: Treatment of primary malignant melanoma of the esophagus remains challenging. We treated a 53-year-old man with pT4N2M0, Stage IVa malignant melanoma of the esophagus with esophagectomy followed by adjuvant chemotherapy. Six months later, computed tomography revealed a 12 cm disseminated tumor of the mesenterium, multiple peritoneal dissemination, and a large amount of ascites. We administered chemotherapy consisting of dacarbazine combined with cisplatin and nimustine, and radiotherapy(50 Gy)was applied to the disseminated mesenteric tumor. At another clinic, the patient was administered synchronous cellular immunotherapy consisting of dendritic cells pulsed with autologous tumor lysates and lymphokine-activated killer cells. The mesenteric tumor was extremely responsive to this trimodal treatment. Because recurrence occurred later within the left orbita muscle, we added 50 Gy of radiation to prevent blindness. The patient responded to this treatment and survived another 6 months with high quality of life. It is difficult to treat advanced malignant melanoma of the esophagus, and patient prognosis is extremely poor. In this patient, the recurrent tumors responded well to trimodal therapy consisting of chemotherapy, radiotherapy and cellular immunotherapy.
authors.affiliation: Dept. of Esophageal Surgery, Akita University Hospital, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Motoyama
authors.forename: Kiyotomi
authors.initials: K
authors.lastname: Maruyama
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sato
authors.forename: Kaori
authors.initials: K
authors.lastname: Shibuya
authors.forename: Shuetsu
authors.initials: S
authors.lastname: Usami
authors.forename: Kei
authors.initials: K
authors.lastname: Yoshino
authors.forename: Toshinobu
authors.initials: T
authors.lastname: Nakatsu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nanjo
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kamata
authors.forename: Junichi
authors.initials: J
authors.lastname: Ogawa
mesh_terms: D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000628:therapy*; D016629:Esophagectomy; D017809:Fatal Outcome; D006801:Humans; D007167:Immunotherapy; D008297:Male; D008545:Melanoma / Q000628:therapy*; D049268:Positron-Emission Tomography; D012008:Recurrence; D014057:Tomography, X-Ray Computed