Primary malignant melanoma of the oesophagus is an uncommon neoplasm comprising less than 0.2% of all primary oesophageal neoplasms. The world literature reports about 250 cases. Several reports suggest that it has a mean survival rate of 2-5% at 5 years and a median survival of 10 months. Dysphagia is the commonest symptom. This tumor has an aggressive biological behavior: hematogenous and lymphatic metastases are very common. A 51 year old female presented to our observation for a four month history of worsening dysphagia associated with regurgitation and weight loss. There was no prior history of cutaneous or ocular melanoma. Diagnosis was done on base of endoscopic biopsies. Staging procedures included chest-abdomen computerized tomography (CT) scan, followed by 18-Flurodeoxyglucose positron emission tomography (FDG PET/CT). She was treated with a combination of subtotal oesophageal resection, mediastinal lynphadenectomy and immuno-modulatory therapy with alfa-interferon. Tha patient is alive and disease-free after 18 month follow-up.
