Background Gastrointestinal (GI) melanomas are uncommon, and the stomach is a rare site for metastasis and accounts for 27% of the cases with GI tract metastatic melanoma. Clinical manifestations are usually nonspecific, and many patients are asymptomatic until the disease progresses further, but may be presented with nausea, vomiting, weight loss, abdominal pain, hematemesis, melena, and iron deficiency. The prognosis is very poor, and the median survival of the patient is 4 to 6 months. The diagnosis is confirmed with postoperative pathological examination and immunohistochemical study. Treatment options include surgical resection, immunotherapy, and targeted therapy. Case Presentation: The presented case is a 71-year-old male, previously diagnosed with cutaneous melanoma of the left retroauricular region, that presented with upper GI tract symptoms and cervical lymphadenopathies about one year after the diagnosis of the primary tumor. An upper GI endoscopy was done, and a pathological examination of the biopsy specimen confirmed the metastatic melanoma of the stomach. Conclusion Regarding the unfavorable outcome of gastric metastatic melanoma, the treatment choice is still under investigation. However, early diagnosis is important for the appropriate assessment of patients as candidates for surgical interventions.
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