Multiple hematogenous metastasis after curative surgery in a patient with pT1a-LPM pN0 primary malignant melanoma of the esophagus

Primary malignant melanoma of the esophagus (PMME) is a rare disease. Here, we describe a case of PMME that was identified at a very early stage. A 65-year-old man underwent upper gastrointestinal endoscopy and was found to have a pigmented small nodule in the lower esophagus. A biopsy was taken and diagnosed as malignant melanoma, so the patient then received radical esophagectomy. Histopathological examination showed atypical cell infiltrate in the lamina propria mucosae without lymph-node metastasis. The patient was followed up without adjuvant chemotherapy. Multiple liver and lung metastases were found at 19 months after surgery, and the patient received DAV-feron (DTIC/ACNU/VCR/IFN-β) therapy. However, the tumors progressed and the patient died of the disease at 27 months after surgery. More detailed surveys after surgery with diagnostic imaging and tumor markers are recommended. Adjuvant chemotherapy is worth considering, even in patients with early-stage PMME.