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January 3, 1977

Gastric Ulcer: An Unusual Presentation of Malignant Melanoma

Author Affiliations

From the Department of Surgery, University of California, Davis, and from the Sacramento Medical Center, Sacramento, Calif.

JAMA. 1977;237(1):52. doi:10.1001/jama.1977.03270280054023

GASTRIC metastases are frequently found during autopsy of patients with malignant melanoma. However, few of these have been diagnosed during life. The following report is concerned with a patient with clinical and radiological findings suggestive of gastric ulcer. A definitive diagnosis of metastatic melanoma was made only six weeks later, when disseminated disease elsewhere was already present.

Report of a Case  A 46-year-old, essentially healthy laborer complained to his family physician of crampy midepigastric pain, weakness, and weight loss. An upper-gastrointestinal radiological study was performed and showed an active gastric ulcer. Ulcer diet, antacids, and anticholinergics were prescribed and were followed by transient relief. Within six weeks of onset, bluish subcutaneous nodules developed on the anterior aspect of the patient's chest and arms. At the same time a pathological fracture of the spinous process of C-7 and melanuria developed. Biopsy of one subcutaneous nodule led to the histologic diagnosis of