Objective: To study the clinicopathological characteristics and CT features of primary malignant melanoma of the esophagus (PMME). Methods: Clinicopathological characteristics and CT findings of 5 cases of PMME confirmed by surgical pathology were retrospectively analyzed

and available literatures were reviewed. Results: The PMME of the 5 patients were all located in the middle and lower esophagus. CT scanning showed that the lesions were irregular nodules or masses protruding into the lumen

and the upper and lower diameters were greater than the transverse diameters. The esophageal wall was not uniformly thickened in the lesion area

while the esophageal wall on the opposite side of the lesion was normal. The masses were inhomogeneous or uniformly enhanced in moderate to severe. Pathological examination showed that 5 cases were fungating type with rough surface

3 cases were dark brown

and 4 cases showed surface erosion. Under light microscope

the tumor cells were in various forms

mostly spindle or round

with voluminous cytoplasm

large nucleolus and common mitosis. Melanin granules were observed in 4 cases. Immunohistochemistry of tumor cells showed positive in S-100

HMB-45 and Melan-A. Conclusion: PMME is rare and has no specific clinical manifestations. Although CT findings have some features

the diagnosis still depends on pathological examination.