Advanced primary amelanotic malignant melanoma of the esophagus: A case report

BACKGROUND Primary malignant melanoma of the esophagus accounts for 0.1%-0.2% of all esophageal malignancies, including melanotic and amelanotic melanomas.Primary amelanotic malignant melanoma of the esophagus is extremely rare, and only about 20 cases have been published in the literature to date. Most primary malignant melanomas of the esophagus are diagnosed following development of metastatic lesions and thus have a very poor prognosis. The median survival duration of patients with metastatic melanoma has been reported to be 6.2 mo.CASE SUMMARY A 49-year-old woman was referred to our hospital with a diagnosis of esophageal cancer. Endoscopy, biopsy, imaging evaluation, and physical examination at our hospital indicated a diagnosis of advanced primary amelanotic malignant melanoma of the esophagus. Immunohistochemical staining confirmed melanoma. Nuclear medicine examination revealed a left iliac bone metastatic lesion. After discharge, the patient self-administered apatinib for 3 mo, followed by oral treatment with Chinese medicines(also self-administered) for 2 mo. No treatments had been taken since then. The patient has survived with no growth out to the most recent follow-up(24 mo post diagnosis), and she always presented with a positive attitude about her condition during this period.CONCLUSION Survival following metastatic melanoma might be related to the pharmaceutical and Chinese medicine treatment and the patient’s positive attitude.