Case report

Posterior mediastinal melanoma causing severe dysphagia: A case report

Elisa Meacci¹ , Antonino Mulè² , Alfredo Cesario^1,2,3 , Claudia Maggiore² and Stefano Margaritora¹

¹  Department of Thoracic Surgery, Catholic University, 'Agostino Gemelli' Hospital, Largo A. Gemelli 8 – 00168 Rome, Italy

²  Department of Pathology, Catholic University, 'Agostino Gemelli' Hospital, Largo A. Gemelli 8 – 00168 Rome, Italy

³  Pulmonary rehabilitation, IRCCS San Raffaele, Via dellaPisana 235 – 00166 Rome, Italy

author email corresponding author email

Journal of Medical Case Reports 2008, 2:316doi:10.1186/1752-1947-2-316

Published:	30 September 2008

Abstract

Introduction

We describe an original case of progressive severe dysphagia caused by a posterior mediastinal metastatic melanoma of unknown origin. To the best of our knowledge, such an event has never been described before in the literature.

Case presentation

A progressive severe dysphagia case is reported induced by a melanoma of unknown origin (metastatic to a posterior mediastinal lymph node). At the time of diagnosis, the lesion appeared as a large posterior mediastinal mass mimicking a neurogenic tumour with oesophageal involvement. After complete resection, pathological assessment of the tumour by immunohistochemistry was consistent with nodal metastatic melanoma.

Conclusion

This report of a posterior mediastinal lymph node melanoma is unique. The nodal origin is definitely unusual: a primary melanoma should always be carefully ruled out. In fact no other evidence, a part from the absence of the tumour elsewhere, can support the diagnosis of a primary nodal melanoma.