食道原発悪性黒色腫の1例

Primary Malignant Melanoma of the Esophagus, Report of a Case

要旨　患者は54歳，男性．下血を主訴に当科受診．下部消化管内視鏡検査にて歯状線より10cmの部位に全周性の2型腫瘍を認め，生検にて高分化型腺癌と診断された．この際スクリーニング目的に施行した上部消化管内視鏡検査にて，胸部中部食道から食道胃接合部直上まで，まだら状に黒色色素沈着を認めた．さらに，胸部下部食道後右壁に径1cm大の広基性隆起を認め，隆起頂部は灰白色であったが，基部は黒色であった．生検にて，悪性黒色腫と診断された．大腸癌は膀胱，仙骨への浸潤を認め，根治切除不能であったため，食道悪性黒色腫に対しては，化学療法を施行した．治療開始後6か月経過し，病変の増大は認めるものの生存中である．

　Malignant melanoma of the esophagus is rare and its prognosis is extremely poor. We report a case of malignant melanoma of the esophagus.

　A 54-year-old man visited our hospital complaining of anal bleeding. Colonoscopy revealed an adenocarcinoma in the rectum. At the same time, upper digestive endoscopy was carried out and revealed a protruded tumor with pigmentation in the lower thoracic esophagus. The surrounding mucosa was also pigmented. Endoscopic biopsy of the tumor was diagnosed as malignant melanoma. The patient received chemotherapy and although the tumor has been growing, he is still alive.