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The time course for tumor progression from a black nodule to PMME. A black nodule was recognized in the mid-thoracic esophagus in 2009 (A). In 2010, a nodule at the same site had grown to 5 mm in size with a slightly raised profile (B), and there was thin mottled black pigmentation around the nodule (C). PMME was confirmed in the mid- thoracic esophagus in 2014 (D).
