Malignant Melanoma of the Stomach

Malignant melanoma with metastasis to the stomach is rare and seldom diagnosed before death. The most common gastrointestinal (GI) metastatic site is the small intestine, followed by the colon, rectum and stomach. We present the case of a 55-year-old woman with a history of melanoma who presented with melena and syncope, and was found to have metastatic gastric melanoma. LEARNING POINTS: It is important to consider gastric metastasis in patients with a history of melanoma who present with non-specific abdominal symptoms such as abdominal pain, nausea, vomiting, melena/haematochezia, weight loss and anaemia. It is crucial to keep gastric melanoma metastasis as a differential diagnosis in a patient with melanoma due to its aggressive nature and poor prognosis if diagnosis is delayed. Appearances can vary greatly at endoscopy, and so immunohistochemistry is vital at histological work-up for the identification of gastric melanoma.