Metastatic melanoma in an esophagus demonstrating Barrett esophagus with high grade dysplasia Public Deposited

Downloadable Content

Download PDF
Creator
  • Greene, Kevin G
    • Affiliation: School of Medicine, Department of Pathology and Laboratory Medicine
  • Weck, Karen E.
    • Affiliation: School of Medicine, Department of Pathology and Laboratory Medicine
  • Shaheen, Nicholas
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology, School of Medicine, Department of Medicine, Division of Gastroenterology and Hepatology
  • Trembath, Dimitri G
    • Affiliation: School of Medicine, Department of Pathology and Laboratory Medicine
  • O’Neill, Stacey
    • Affiliation: School of Medicine, Department of Pathology and Laboratory Medicine
Abstract
  • Abstract Background Metastatic melanoma involving the esophagus is rare; the occurrence of metastatic melanoma in a background of Barrett esophagus is rarer still. We report a case of an 80 year-old male who presented to our institution for workup of Barrett esophagus with high-grade dysplasia and who proved to have metastatic melanoma occurring in the background of Barrett esophagus, the first report of this kind, to our knowledge, in the English literature. Case presentation An 80 year-old Caucasian male was diagnosed at an outside institution with Barrett’s esophagus with high grade dysplasia and presented to our institution for therapy. The patient underwent endoscopic mucosal resection using a band ligation technique of an area of nodularity within the Barrett esophagus. Microscopic examination demonstrated extensive Barrett esophagus with high-grade dysplasia as well as a second tumor which was morphologically different from the surrounding high-grade dysplasia and which was positive for S-100, HMB 45 and Melan-A on immunohistochemistry, consistent with melanoma. Further workup of the patient demonstrated multiple radiologic lesions consistent with metastases. Molecular studies demonstrated that the melanoma was positive for the 1799T>A (V600E) mutation in the BRAF gene. The overall features of the tumor were most consistent with metastatic melanoma occurring in a background of Barrett esophagus with high-grade dysplasia. Conclusion This case demonstrates a unique intersection between a premalignant condition (Barrett esophagus with high grade dysplasia) and a separate malignancy (melanoma). This report also shows the utility of molecular testing to support the hypothesis of primary versus metastatic disease in melanoma.
Date of publication
Identifier
  • doi:10.1186/1756-0500-6-457
Resource type
  • Article
Rights statement
  • In Copyright
Rights holder
  • Dimitri G Trembath et al.; licensee BioMed Central Ltd.
License
Journal title
  • BMC Research Notes
Journal volume
  • 6
Journal issue
  • 1
Page start
  • 457
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1756-0500
Bibliographic citation
  • BMC Research Notes. 2013 Nov 13;6(1):457
Access
  • Open Access
Publisher
  • BioMed Central Ltd
Parents:

This work has no parents.

Items