A case of primary malignant melanoma of the esophagogastric junction with abscopal effect after nivolumab administration

Abstract Background The abscopal effect is a rare phenomenon in which local irradiation causes tumor regression outside the irradiated area. There have been no reports of abscopal effect in patients with gastrointestinal melanoma with metastasis. Here, we report a case of primary malignant melanoma of the esophagogastric junction with abscopal effect after long-term treatment with nivolumab. Case presentation A 75-year-old woman was referred to our hospital with a gastroesophageal lesion. Upper gastrointestinal endoscopy revealed a raised lesion on the posterior wall of the greater curvature of the cardia and tenderness in the lower esophagus. Immunostaining of the tumor biopsy showed positive staining for Melan-A, human melanoma black-45 (HMB45), and S-100, indicating malignant melanoma of the esophagogastric junction. Contrast-enhanced computed tomography (CT) of the abdomen showed a mildly stained lesion protruding into the cardiac part of stomach and enlarged surrounding lymph nodes. The patient was diagnosed with malignant melanoma of the esophagogastric junction and proximal gastrectomy with lower esophagus resection was performed. Histological examination showed large, round tumor cells with nuclear atypia. Immunostaining was positive for Melan A, HMB45, S-100 protein, and SRY-box transcription factor 10, and the final diagnosis was malignant melanoma of the esophagogastric junction, with regional lymph node metastases. Three months after surgery, follow-up CT indicated left pleural metastasis; therefore, the patient was administered nivolumab, an immune checkpoint inhibitor (ICI). Following three courses of nivolumab, the patient exhibited grade 3 renal dysfunction (Common Terminology Criteria for Adverse Events version 5.0). After that, we have not administered nivolumab treatment. Five months after the development of renal dysfunction, a CT scan demonstrated an unstained nodule within the pancreatic, and the patient was diagnosed with pancreatic metastasis; intensity-modulated radiotherapy was performed. Six months later, CT revealed pancreatic nodule and pleural metastasis was shrunk; after an additional 2 months, pleural metastasis and effusion had disappeared. The patient is alive with no additional lesions. Conclusions We report a case of primary malignant melanoma of the esophagogastric junction with an abscopal effect following nivolumab treatment. The findings of this case report suggest that ICIs in combination with radiotherapy may be effective for treating metastatic or recurrent malignant melanoma of the gastrointestinal tract.

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A Case of Primary Subglottic Malignant Melanoma with a Successful Surgical Treatment

Case Reports in Oncological Medicine ◽

10.1155/2014/968926 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Shahzad Ahmad ◽

Mahmoud Abdelghany ◽

Curtis Goldblatt ◽

Owen Stark ◽

Nicholas Masciotra

Keyword(s):

Surgical Treatment ◽

Malignant Melanoma ◽

Excisional Biopsy ◽

Human Melanoma ◽

Primary Malignant Melanoma ◽

Shortness Of Breath ◽

S 100 ◽

Hmb 45

Primary subglottic malignant melanoma is a very rare and underdiagnosed neoplasm. We are reporting a case of primary malignant melanoma of subglottic mucosa in a 78-year-old woman who presented to our hospital with shortness of breath and hoarseness of voice. Laryngoscopy and excisional biopsy along with immunoreactivity to S-100 and human melanoma black-45 (HMB-45) confirmed the diagnosis. The patient was treated with laryngectomy followed by radiotherapy. Five years following surgical treatment, she continues to be asymptomatic. To our knowledge, there is only one reported case of primary malignant melanoma of subglottic mucosa in the medical literatures.

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Primary Melanoma of the Lung: A Systematic Review

Medicina ◽

10.3390/medicina56110576 ◽

2020 ◽

Vol 56 (11) ◽

pp. 576

Author(s):

Panagiotis Paliogiannis ◽

Antonella M. Fara ◽

Gianfranco Pintus ◽

Wael M. Abdel-Rahman ◽

Maria Colombino ◽

...

Keyword(s):

Malignant Melanoma ◽

Single Case ◽

Left Lung ◽

Case Series ◽

Primary Melanoma ◽

Primary Malignant Melanoma ◽

S 100 ◽

Main Determinants ◽

Mitotic Figures ◽

Rare Malignancy

Background and Objectives: The respiratory apparatus, generally affected by highly aggressive tumors like lung cancer and mesothelioma, is rarely affected by primary malignant melanoma. The aim of this review was to identify cases of primary malignant melanoma of the lung (PMML) published in the modern scientific literature, and to describe their main clinical, pathological and therapeutic features. Materials and Methods: A systematic search of publications in the electronic database PubMed has been performed using keywords, and the references of the selected articles were checked to identify additional missing studies. Results: Globally 52 papers reporting on 76 cases were identified. Among them there were 47 reports of a single case, three papers reporting on two cases each, and two larger case series published in 1997 and 2005 including eight and 15 cases, respectively. Conclusions: PMML was generally diagnosed in middle-aged males, without any apparent correlation with cigarette smoking. It was more frequently found in the lower lobes and the left lung. The tumors were generally pigmented, composed by epithelial and/or spindle cells with large nuclei and prominent nucleoli, nuclear atypia, and numerous mitotic figures; they commonly showed immunostaining for S-100, HMB 45 and Melan-A. Early detection and surgical resection were the main determinants of survival from this rare malignancy.

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PS02.192: TWO CASES OF PRIMARY MALIGNANT MELANOMA OF ESOPHAGUS TREATED WITH SUBTOTAL ESOPHAGECTOMY

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps02.192 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 176-176

Author(s):

Ryosuke Hirohata ◽

Manabu Emi ◽

Yoichi Hamai ◽

Yuta Ibuki ◽

Morihito Okada

Keyword(s):

Lymph Node ◽

Survival Rate ◽

Malignant Melanoma ◽

Lymph Node Metastasis ◽

Surgical Resection ◽

Primary Malignant Melanoma ◽

Lower Esophagus ◽

Subtotal Esophagectomy ◽

Node Metastasis ◽

Upper Gastrointestinal

Abstract Background Malignant melanoma of the primary esophagus is rare, in general it has high malignancy and poor prognosis. We report two cases of early-stage primary malignant melanoma of esophagus (PMME) underwent subtotal esophagectomy. Methods Case presentation Results [Case 1]A 66-year-old man was pointed out a black legion on the lower esophagus by upper gastrointestinal endoscope for screening purposes. The lesion was diagnosed as malignant melanoma by biopsy. In addition, another black lesion was also found in the pharynx, but there was no malignant cell. Other examinations did not reveal any findings of lymph node metastasis and distant metastasis. We diagnosed PMME (T1aN0M0 Stage 0) and performed surgical resection. Pathologically it was pT1a (LPM), pN0. There is no recurrence, and it is under observation. [Case 2] A 51-year-old woman was conducted upper gastrointestinal endoscopy for the purpose of scarring epigastric pain, and a black lesion was pointed out in lower esophagus. Surgical resection was performed with diagnosis of PMME (T1bN0M0 Stage I). The pathological stage was pT1a (MM), pN0. Conclusion The 5 year survival rate of malignant melanoma of primary esophagus is poor with about 30 to 35%, and especially in cases with lymph node metastasis, the survival rate further decreases. The both cases were discovered accidentally by endoscopic examination, leading to early diagnosis and early treatment. Therefore, long survival is expected. There is also a report that melanosis is associated with melanoma, so case 1 requires careful follow-up observation. Disclosure All authors have declared no conflicts of interest.

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Primary malignant melanoma of the esophagogastric junction

Medicine ◽

10.1097/md.0000000000026467 ◽

2021 ◽

Vol 100 (25) ◽

pp. e26467

Author(s):

Yu-Ming Chu ◽

Chih-Sheng Hung ◽

Ching-Shui Huang

Keyword(s):

Malignant Melanoma ◽

Esophagogastric Junction ◽

Primary Malignant Melanoma

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Primary Spinal Cord Melanoma of Intradural Extramedullary Origin

Journal of Neurosciences in Rural Practice ◽

10.1055/s-0039-1697559 ◽

2019 ◽

Vol 10 (03) ◽

pp. 522-525

Author(s):

Ashish Sharma ◽

Virendra Deo Sinha

Keyword(s):

Spinal Cord ◽

Malignant Melanoma ◽

Histopathological Examination ◽

Lower Limbs ◽

Primary Malignant Melanoma ◽

Magnetic Resonance Imaging Scan ◽

Lumbosacral Region ◽

Intensity Lesion ◽

S 100 ◽

L1 And L2

AbstractPrimary malignant melanoma is the very rare entity of the central nervous system. It accounts only 1% of all melanoma cases. A 67-year-old patient presented to us with lower back pain radiating to the left lower limb and progressive weakness of both lower limbs. She underwent magnetic resonance imaging scan of lumbosacral region that suggested T1 hyperintense, T2 hypointense, extramedullary altered signal intensity lesion at L1 and L2 vertebral level compressing terminal spinal cord, and cauda equine region. On histopathological examination, findings were suggestive of malignant melanoma that was confirmed with immunohistochemistry examination (positive for S-100, Melan-A, and HMB-45). Here, we are discussing an unusual case of primary malignant melanoma of conus and cauda equine region with comprehensive review regarding management and prognosis of the tumor.

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Primary malignant melanoma of the esophagogastric junction: Report of a case

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2013.04.037 ◽

2013 ◽

Vol 4 (8) ◽

pp. 700-703 ◽

Cited By ~ 3

Author(s):

Masahiro Ishizaki ◽

Yasushi Aibara ◽

Keizo Furuya

Keyword(s):

Malignant Melanoma ◽

Esophagogastric Junction ◽

Primary Malignant Melanoma

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Primary Malignant Melanoma of Vagina: A Clinicopathologic Analysis of 6 Cases

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqab191.169 ◽

2021 ◽

Vol 156 (Supplement_1) ◽

pp. S80-S80

Author(s):

Y Xiang ◽

X G Xu ◽

X Zhang

Keyword(s):

Malignant Melanoma ◽

Adjuvant Therapy ◽

Progression Free Survival ◽

Primary Malignant Melanoma ◽

Depth Of Invasion ◽

Term Survival ◽

Free Survival ◽

Pathologic Features ◽

S 100

Abstract Introduction/Objective Primary malignant melanoma of vagina (PMMV) has a very high rate of recurrence and poor long-term survival. Less than 250 cases are reported in English literature to date, optimal treatments, risk factors, and prognostic predictors for PMMV are still subjects of debate. This study sought to evaluate the clinicopathologic features, initial management, and survival of 6 patients over 7 years follow-up in one institution. Methods/Case Report In this study, the clinical and pathologic features of 6 PMMV occurring in patients age 49 to 83 years were evaluated retrospectively. The mean age of the patients was 68.2 years, and all patients were postmenopausal women. At the time of diagnosis, all tumors were limited to the vagina. Results (if a Case Study enter NA) Vaginal bleeding, discharge and a tumor mass were the chief complaints. These patients were treated by pelvic exenteration, radical surgery and postoperative chemotherapy and/or radiotherapy. Follow-up was available in all patients ranging from 1 to 7 years. Two patients had metastases in other organs died at 16 and 34 months respectively. Two patients had distant recurrence at 1 to 2 years and are still alive. The other 2 patients have no evidence of disease over 2 years follow-up. Grossly, the tumors were mostly polypoid and ranged from 0.25 to 9.5 cm (mean, 5 cm) in maximum dimension. The depth of invasion ranged from 2.2 to 11 mm. A vertical growth phase was present in all tumors. S-100, HMB-45 and Melan-A were positive in 100% of cases tested. Depth of invasion, mitotic index of tumor cells, tumor size, age, menopausal status, pelvic lymph node metastasis and lymphocytic infiltration show no tendency towards progression-free survival. Patients with positive or indeterminate margin status demonstrated a higher risk of recurrence than did patients with negative margins. And adjuvant therapy was associated with progression-free survival. Conclusion In conclusion, PMMV is a rare disease, predominantly seen in women of postmenopausal age, and is associated with a poor prognosis. This study confirms S-100, HMB-45and Melan-A remains the most sensitive marker. Conventional predictors were of no prognostic value. Positive margin and adjuvant therapy were associated with progression-free survival. This report can facilitate the expansion of the phenotypic spectrum of gynecologic melanomas, and contribute to the prevention of misdiagnosis and inadequate treatment of PMMV.

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Primary malignant melanoma of female urethra: a case report and review of literature

Journal of Oncology Research ◽

10.30564/jor.v1i3.1975 ◽

2020 ◽

Vol 1 (3) ◽

Author(s):

Shashank Agrawal ◽

Tak GR ◽

Aditya Parikh ◽

Arvind Prakash Ganpule ◽

Abhishek Gajendra Singh ◽

...

Keyword(s):

Case Report ◽

Malignant Melanoma ◽

Protein S ◽

Primary Malignant Melanoma ◽

Female Urethra ◽

Inguinal Lymph Node Dissection ◽

Rare Case Report ◽

S 100 ◽

History Of ◽

Poorly Differentiated

We report an extremely rare case report of primary malignant melanoma of female urethra. A 65 years old diabetic elderly postmenopausal female presented with a history of intermittent blood spots on undergarments for few days. Genital examination revealed a single, tan colored, soft chestnut size and polypoidal non ulcerated mass lesion protruding through the urethral meatus. Mass biopsy revealed poorly differentiated epithelial malignancy and immuno-histological analysis revealed positive with HMB 45 and protein S-100 suggestive of melanoma. Metastatic work up for the malignancy was negative. Complete urethrectomy with Mitrofanoff procedure with inguinal lymph node dissection was performed. Pathological diagnosis was malignant melanoma of urethra. We discuss the clinicopathological features and treatment option possible in this scenario.

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