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A 27-year-old man presented with a large solitary lung mass. Transbronchial lung biopsy and lobectomy specimens showed malignant melanoma. A thorough search for a primary melanoma lesion, including an ophthalmic exam and a dermatologic exam with special attention to the skin, mucous membranes, genitals, perineum, scalp, and nails showed no lesions suspicious for a melanoma. The diagnosis of primary malignant melanoma of the lung was considered. Whole-body positron emission tomography scan with computed tomography fusion imaging at the time of diagnosis showed no evidence of tumor outside the chest, and the diagnosis of primary malignant melanoma of the lung was confirmed. The prognosis of patients with this exceedingly rare neoplasm is poor, though surgical intervention may be warranted in some cases.
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