A 57-year-old woman presented with appetite loss, malaise and dyspnea in August 2007. Chest radiograph showed left pleural effusion and thickening of the left pleura, and thoracic drainage was performed. Positron emission tomography (PET) showed multiple sites of uptake within the left pleura indicating malignant tumors. No uptake was seen in other parts of her body. An open lung biopsy disclosed multiple black-colored masses widely disseminated in the left thoracic cavity, and partial resection was performed. Pathological diagnosis was malignant melanoma. She was admitted to our hospital in September 2007. Repeated physical examinations failed to reveal any site for the primary melanoma in the skin, eyes, oral cavity, or genital or anal regions, and neither computed tomography (CT) nor PET showed masses in other parts of her body. Thus, a diagnosis of primary malignant melanoma of the pleura was made. Beginning in October 2007, she received 2 courses of DAC-Tam (DTIC, ACNU, CDDP and Tamoxifen) therapy, a single course of CDV (CDDP, DTIC, VDS) therapy, and then 6 courses of triweekly paclitaxel therapy. But metastasis to the liver and abdominal lymph nodes appeared. Chemotherapy was discontinued and beginning in August 2008, she was treated with subcutaneous injection of IFN-β every other week. However, she died from multiple metastases in May 2009, a year and 9 months after the diagnosis.
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