A Rare Presentation of Cystic Metastatic Melanoma in the Upper Chest

A 57-year-old male was evaluated for a smooth cystic nodule on his left upper chest that appeared clinically to be a cyst, yet histopathology and confirmatory immunohistochemistry revealed invasive malignant melanoma. Histopathologic evaluation and immunohistochemical staining (i.e., SOX-10 and MART-1) are useful diagnostic tools for invasive malignant melanoma that, albeit rare, can present without known or cutaneous primary. This case illustrates the variability with which metastatic melanoma can present, calling attention to the importance of careful evaluation of benign-appearing and asymptomatic lesions.