• Juan Peng, Fengfeng Han, Tianyun Yang, Jinyuan Sun, Wenbin Guan, and Xuejun Guo.
• aDepartment of Respiratory Medicine bDepartment of Pathology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
• Medicine (Baltimore). 2017 Nov 1; 96 (46): e8772.

RationalePrimary malignant melanoma of the lung (PMML) is an extremely rare neoplasm with a dismal prognosis. The diagnosis of PMML is very difficult and is based on several clinical, radiological, and histopathological criteria.Patient ConcernsA 61-year-old women was admitted with a 2-month history of a productive cough and chest pain provoked by breathing and coughing. Computed tomography (CT) scans of the chest showed a large, solid tumor in the right middle lobe of the lung. Puncture biopsy of the right lung lesion was performed using B-ultrasound guidance, and immunohistochemical tests were performed.DiagnosesThe diagnosis of PMML was histopathologically confirmed by puncture biopsy with B-ultrasound guidance of the right lung lesion.InterventionsThe patient refused to receive surgery, adjuvant chemotherapy, or radiation therapy.OutcomesThe patient died 6 months after the diagnosis.LessonsThe clinical manifestation and imaging features of PMML are not specific, and it does not differ from the more common primary bronchogenic carcinoma. In addition, it cannot be discriminated from other forms of primary melanoma according to its histology and immunohistochemistry. The treatment of choice is an aggressive surgical approach, combined with radiation therapy, chemotherapy, and immunotherapy.

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