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Key Clinical MessageMetastatic male occult HER2‐positive breast cancer can be successfully treated with trastuzumab monotherapy.

Primary malignant melanoma of the esophagus is a rare disease that tends to demonstrate an extremely poor prognosis. We herein describe a case of primary malignant melanoma of the esophagus that was successfully treated. The tumor was incidentally detected by a barium swallow examination performed during a routine medical checkup. The tumor was resected by a transhiatal radical esophagectomy. Histologically, the tumor metastasized to one of the perigastric lymph nodes, although tumor invasion was confined to the submucosa at the primary site. Immunohistochemically, the tumor cells were strongly positive for S100 protein and HMB-45. Postoperatively, systemic chemotherapy consisting of DTIC, ACNU, and VCR was administered. The patient has survived without recurrence for 12 months after these treatments. A transhiatal esophagectomy followed by systemic chemotherapy may therefore be an effective treatment for potentially curable primary melanoma of the esophagus.

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