[Cholecystitis as the first manifestation of metastatic melanoma]

The incidence of invasive melanomas increases annually by 3-4%; for melanoma in situ, even by 6-7%. While metastases most commonly occur in the skin, lungs, liver, and brain, abdominal spread, including to the gallbladder, is not uncommon.

We present a 59-year-old man with a previously treated melanoma on the scalp. He presented with recurrent abdominal pain and a history of melaena. Due to suspicion of cholecystitis, he underwent emergency surgery, which revealed a gallbladder metastasis of the melanoma.

Gastrointestinal metastases of melanoma are frequently asymptomatic and are often diagnosed only upon the occurrence of complications such as obstruction, hemorrhage, or perforation. Nonetheless, metastases to the gallbladder in the context of advanced melanoma are not uncommon. In patients with a prior history of melanoma presenting with new-onset abdominal symptoms or iron deficiency anemia, metastatic involvement of intra-abdominal organs should be considered in the differential diagnosis. Given the often multifocal nature of intra-abdominal melanoma metastases, comprehensive imaging and histopathological evaluation are critical for accurate diagnosis. Management is primarily systemic and requires a multidisciplinary approach; surgical intervention may be indicated in selected cases with symptomatic disease.