ABSTRACT
A 65-year-old woman with dysphagia visited our outpatient clinic. Esophagogastric endoscopy revealed a number of black-brown, irregularly elevated lesions covering the mucosal layer of nearly the entire esophagus. Following a series of examinations including histological examinations of the biopsies and whole body FDG-PET/CT, the patient was diagnosed with malignant melanoma primarily of the esophagus with metastasis to the distant lymph nodes, duodenum, pancreas head, and left brachial bone [cT3N3M1, StageIVb]. Since surgicalresection was not indicated, dacarbazine (DTIC: 1,000mg/m² body surface area)was intravenously administered 7 times every 3 weeks on an outpatient basis. However, the disease was progressive and metastasized to the stomach, duodenum, and small intestine, and finally to the brain. The patient died 8 months after the diagnosis was made. Malignant melanoma of the esophagus is a relatively rare pathology, and no reliable therapeutic modalities have been established yet. Based on the present case, the effectiveness of DTIC in an advanced case is proposed to be limited. In addition, whole body FDG-PET/CT is very useful for detecting metastatic lesions that could be missed otherwise.
