We have experienced three cases of primary malignant melanoma of the esophagus over the past ten years. All three patients complained of dysphagia. All the tumors were elavated or polypoid lesions located in the middle-lower portion of the esophagus, as is usual with esophageal melanoma. Case 1, a 69-year-old male. As the endoscopic biopsy specimen was diagnosed as anaplastic carcinoma, preoperative irradiation was carried out. Though the tumor size was definitely decreased four months after

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... gnosis, there were multiple metastases of the liver and lung at surgery. The patient died one month after the palliative resection. Case 2, a 60-year-old male. Multiple metastases were already apparent at the diagnosis. Chemo-endocrine therapy (DAV, OK432) was selected, but was not effective. The patient died six months after admission. Case 3, a 56-year-old female. Lower esophagectomy with total gastrectomy was performed one month after the diagnosis, and postoperative adjuvant chemotherapy (DAV) was added. This patient has survived for sixteen months with no evidence of recurrence. Early hematogenic or lymphogenic metastasis is common in the case of malignant melanoma of the esophagus. Our three cases suggest that early resection following diagnosis, associated with postoperative irradiation or chemo-endocrinetherapy, is the best choice for long-term survival of patients with malignant melanoma of the esophagus.