Black pigmented dysphagia

A 63-year-old male of Turkish origin was referred to our department for further investigation of dysphagia for solids since 2 years with recent occurrence of food impaction. The patient had no significant medical history besides smoking. There was no mention of weight loss or other systemic complaints. Upper gastrointestinal endoscopy showed a large subobstructive pedunculated mass in the lower thoracic esophagus. The lesion was remarkably pigmented and seemed to be infused with Chinese ink (see figure 1). Biopsies were taken.