Black Urine and Black Pleural Fluid: A Distinctive Presentation of Metastatic Melanoma

Metastatic melanoma is an uncommon clinical entity which can have an unusual presentation. We describe a patient with metastatic melanoma who presented with diffuse melanosis cutis, black urine and black pleural effusion. Very few medical conditions can cause black discoloration of body fluids, so this should prompt physicians to search for a number of potential underlying causes. LEARNING POINTS: Diffuse melanosis cutis is a rare presentation of metastatic melanoma. Malignant melanoma with thoracic metastases can cause a black pleural effusion. Physicians should be aware of potential causes of black discoloration of body fluids.