title: Signet-ring cell melanoma of the gastroesophageal junction: a case report and literature review.
abstract: We report the first case, to our knowledge, of a possible primary, signet-ring cell melanoma of the gastroesophageal junction. The mass was initially diagnosed as an invasive, poorly differentiated carcinoma; however, on further review and immunohistochemical workup, the diagnosis of signet-ring cell melanoma was made. The lesion consisted of oval to round epithelioid cells undermining the gastric mucosa and infiltrating the muscularis mucosae. Tumor cells demonstrated abundant cytoplasm and eccentrically located nuclei, many with signet-ring cell morphology. The tumor cells were negative for mucin and pancytokeratin, strongly positive for S100 protein and Melan-A, and focally but strongly positive for human melanoma black-45. Diagnostic imaging failed to prove another site of melanoma, and no history of melanoma or cutaneous lesion was reported by the patient. Therefore, it was determined this was likely a primary lesion. We review the literature and previously reported cases of this rare histologic variant of melanoma.
authors.affiliation: Department of Anatomic Pathology, Cleveland Clinic, Ohio 44195, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Grilliot
authors.forename: John R
authors.initials: JR
authors.lastname: Goldblum
authors.forename: Xiuli
authors.initials: X
authors.lastname: Liu
mesh_terms: D000368:Aged; D018279:Carcinoma, Signet Ring Cell / Q000175:diagnosis* / Q000378:metabolism; D003937:Diagnosis, Differential; D004943:Esophagogastric Junction / Q000737:chemistry / Q000473:pathology*; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D058965:MART-1 Antigen / Q000032:analysis; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000378:metabolism; D058950:Melanoma-Specific Antigens / Q000032:analysis; D009418:S100 Proteins / Q000032:analysis; D058951:gp100 Melanoma Antigen
chemical_list: D058965:MART-1 Antigen; D058950:Melanoma-Specific Antigens; C548637:PMEL protein, human; D009418:S100 Proteins; D058951:gp100 Melanoma Antigen