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A primary tumour of the oesophagus with both melanocytic and schwannian differentiation. Melanocytic schwannoma or malignant melanoma?
  1. R M Brown1,
  2. S J Darnton2,
  3. L Papadaki1,
  4. G N Antonakopoulos3,
  5. J Newman1
  1. 1Department of Histopathology, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK
  2. 2Oesophageal Research Laboratory, Department of Thoracic Surgery, Birmingham Heartlands Hospital
  3. 3Faculty of Health Sciences, University of Thessaly Medical School, 412 22 Larissa, Greece
  1. Correspondence to:
 Dr S J Darnton, Oesophageal Research Laboratory, Department of Thoracic Surgery, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK;


A 76 year old white woman presented with a four month history of dysphagia and weight loss. Clinical, radiological, and endoscopic examination revealed a pigmented mass in the lower third of the oesophagus. The preoperative diagnosis, including biopsy examination, was that of malignant melanoma. Following oesophageal resection, the mass was found to be a localised, relatively superficial tumour with light, electron microscopic, and immunohistochemical features common to both Schwann cells and melanocytes. The patient survived 46 months after surgery and died of a stroke, with no evidence of tumour recurrence. The tumour is presented as a case of melanocytic schwannoma, with unique features when compared with oesophageal melanotic schwannomas and malignant melanomas described in the literature. The differential diagnosis is discussed and an origin from a common precursor cell of neural crest origin is postulated.

  • oesophageal neoplasms
  • schwannoma
  • melanoma

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