Α 75 year-old male with a solitary pulmonary mass, pleuritic pain and persistent fever

SUMMARY.The lung is an extremely rare primary site for the developmentof malignant melanoma, in contrast with other tissues where thistumour presents, such as skin, head and neck mucosa, eyes and thegastrointestinal tract. Primary malignant melanoma of the lungs(PMML) is a diagnostic challenge, as clinically and radiologicallyit cannot be distinguished from the usual primary bronchogeniclung cancer, and its histopathological and immunohistochemicalcharacteristics are little different from those of a lung metastasisfrom another primary site of malignant melanoma, which is morecommon. Its diagnosis is based on a number of clinical, radiologicaland histopathological criteria. In addition, because of its rarity,the knowledge and experience about the prognosis and treatmentmodalities concerning PMML are inadequate, due to lack of largeseries. From the little that we know, it appears to be a tumour withpoor prognosis, which should be treated by radical surgery, if thisis possible, followed by adjuvant chemotherapy and radiotherapy,practically the same as those used for skin melanomas. Metastasesto the spleen are an unusual manifestation of malignant melanoma,and may be the cause of continuous high fever. Pneumon 2011,24(1):411-416