S4538 A Rare Case of Gastric Metastases From Cutaneous Melanoma Presenting as Dyspepsia

Introduction: Metastatic melanoma to the gastrointestinal (GI) tract is uncommon, with the stomach being an infrequent site of involvement. When present, it can be clinically silent or present with nonspecific symptoms, posing a diagnostic challenge. Case Description/Methods: Seventy-two-year-old man with a prior history of Stage IB cutaneous melanoma of the right shoulder, status post resection, presented with dyspepsia and mild post-prandial nausea. Esophagogastroduodenoscopy (EGD) revealed multiple 3–5 mm flat, polypoid, darkly pigmented lesions scattered throughout the stomach. Biopsies of the lesions were obtained. Histopathological examination demonstrated metastatic malignant melanoma in a background of mild chronic gastritis; testing was negative for Helicobacter pylori. The patient was subsequently referred to oncology for further management of metastatic disease. Discussion: Although rare, gastric metastases from melanoma should be considered in patients with a history of melanoma who present with new upper GI symptoms. Endoscopic findings can vary, and diagnosis relies on histopathological confirmation. Early recognition is essential to guide appropriate oncologic management.