Amelanotic esophageal malignant XXXX : case report and short review of the literature.

@entity1 @entity353 @entity5 @entity254 @entity1208 @entity1282 @entity3 @entity810 @entity320
@entity320 in the esophagus is a rare condition which has been described only occasionally in case reports or in larger series of @entity1 with @entity1208 . We describe here the very rare case of a @entity1 who presented initially with a 2-month history of @entity1282 and @entity353 which led to the endoscopic diagnosis of an unclear lesion in the distal esophagus. Biopsies were taken revealing positive immunohistochemical staining against HMB-45. As there were no signs of @entity320 and there was an absence of pigmentation, a diagnosis of primary amelanotic malignant @entity320 was made. Primary staging of the lesion was completed with computed tomography (CT), which revealed a locally advanced @entity5 with lymph node @entity3 at the lesser curvature of the stomach and celiac trunk. As there is still a lack of potential protocols for multimodal neoadjuvant treatment for this rare @entity5 entity, a palliative abdominothoracic esophagectomy with systemic lymphadenectomy and intrathoracic @entity254 was carried out. Due to an intraoperative R2 situation, clip marking was performed to allow postoperative radiotherapy. Two months postoperatively, the planning CT scan for radiotherapy revealed @entity5 mass, which was enclosing the celiac trunk, renal vein, and superior mesenteric artery. Multiple new liver and lung @entity3 were also found. During the following weeks, the @entity1 developed @entity810 and was admitted for dialysis, and the planned radiotherapy was deferred. At the end of May 2007, 4 months after the primary diagnosis, the @entity1 died due to @entity810 .
