PMC5694584_01
H+E stain showing the tumor cells replacing the squamous mucosa (left side, 10x). Discohesive malignant tumor cells growing in sheets (H&E, right, 20x).
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Histology showed discohesive, small to medium sized cells, arranged primarily in solid nests, with focal necrosis (Figure 1).
Pagetoid involvement of the squamous mucosa by the neoplastic cells (H&E, 20x).
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There was focal pagetoid involvement of the overlying squamous mucosa (Figure 2).
The malignant cells are positive for Melan-A and CD56 with a negative cytokeratin AE1/AE3.
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Then, stains for malignant melanoma were performed and demonstrated that the neoplastic cells were focally positive for S-100 protein while other MM markers including Melan-A and SOX10 were diffusely positive (Figure 3).
PET scan demonstrating a hypermetabolic mass in the distal esophagus. Also, a hypermetabolic liver lesion and an enlarged gastroesophageal lymph node are seen. This PET scan incidentally revealed bilateral hypermetabolic thyroid lesions.
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It also revealed a 2 cm hypermetabolic liver lesion and hypermetabolic gastroesophageal lymph node (Figure 4).