Abstract
A 68-year-old man was referred to our hospital with general fatigue in July 2010. Blackish nodular lesion 15 mm diameter were noted on the skin at the top of his head. Chest and abdominal computed tomography images revealed bilateral mediastinal and hilar lymphadenopathy, with multiple lung and liver metastases. He was hospitalized due to severe malaise, and diagnosed histopathologically with a bone marrow puncture as having malignant melanoma with systemic metastases. Endoscopic examination undertaken due to anemia showed multiple blackish lesions in the esophagus, stomach, and duodenum, and biopsy of the gastric lesion led to the diagnosis of metastatic malignant melanoma. Although chemotherapy was planned, the patient's general condition deteriorated quickly and he died three weeks after the initial visit. Malignant melanoma metastases in the gastrointestinal tract are relatively more commonly seen in autopsies on patients with disseminated melanoma, but are rarely diagnosed ante-mortem because of the nonspecific symptoms and signs of metastases, which include appetite loss, weakness, fatigue, bleeding, anemia, and abdominal pain.
