Abstract
Background. Malignant melanoma is a disease with an extremely poor prognosis that easily develops lymphogenous and hematogenous distant metastasis. Case. A 56-year-old man was referred because of abdominal pain in the left side and general fatigue. Radiologic imaging showed a mass and a small nodule in the lung, a mass with peritumoral edema in the left brain, bilateral enlarged adrenal glands, and nodules in both lobes of the thyroid gland. Both transbronchial biopsy and percutaneous needle biopsy of the thyroid gland demonstrated a pathologically malignant melanoma, but neither skin lesions nor eye lesions were observed. Although the patient showed progressive anemia with black-colored feces, neither esophagogastroduodenoscopy nor colonoscopy showed the presence of any abnormal lesions. However, capsule endoscopy showed a tumor with brownish pigmentation which suggested malignant melanoma in the small intestine. Therefore, the patient was given a diagnosis of multiple metastases of a malignant melanoma of unknown origin. Conclusion. This is a rare case of multiple metastatic malignant melanoma according to the findings of both bronchoscopy and capsule endoscopy.
