Joseph C. Yarze, MD
Massachusetts General Hospital, Boston, MA
Introduction: To describe a case of melanoma metastatic to the esophagus.
Case Description/Methods: A 65 yo male with a prior history of hypertension and melanoma of the scalp treated with MOHS in 2011 presented in 1/19 for direct-access EGD to evaluate chronic reflux symptoms (which were responsive, but PPI-dependent). The EGD was normal aside from revealing an 8 mm, deeply pigmented, raised nodule in the upper esophagus at 30 cm from the incisors (figure 1). Biopsies revealed malignant melanoma (lesional cells positive for SOX10 and MiTF; negative for MN116). The patient was referred to medical oncology. PET-CT staging of the chest and abdomen were negative and brain MRI was normal. After multidisciplinary consideration, the patient underwent esophageal EUS and ESD of the esophageal lesion. The resected melanoma lesion was confined to the mucosa. After further consideration, the patient opted to undergo adjuvant therapy with nivolimumab.
Discussion: While malignant melanoma has a known propensity to metastasize to the GI tract, esophageal metastases are uncommon. Our patient was found to have an asymptomatic esophageal metastatic lesion, which was found incidentally when he underwent EGD to evaluate chronic reflux symptoms. He was successfully treated with ESD of the localized metastatic lesion followed by adjuvant nivolimumab therapy.
Citation: Joseph C. Yarze, MD. P1205 - MELANOMA METASTATIC TO THE ESOPHAGUS. Program No. P1205. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.