Severe hepatocellular disease as an unusual presentation of metastatic melanoma

Melanoma is a cutaneous malignancy with an incidence that is rising. Surgery is curative if performed prior to metastasis. Liver metastasis is common and is often associated with an elevation in lactic dehydrogenase. A rise in transaminases is unusual; typically it is low in these patients. We describe a case of metastatic melanoma which presented as severe hepatocellular disease.