Melanomas represent 3% of all skin cancers but 65% of skin cancer deaths. Metastatic melanoma constitutes about 5% of all secondary malignancies of the lung, yet only 2% of patients with thoracic metastases have pleural effusions. We report the case of an 80-year-old patient with right-sided pleural effusion and a history of cutaneous melanoma over the left leg. Thoracoscopy revealed numerous clusters of pink and black masses arising from the visceral and parietal pleura along with the diaphragmatic surface. Biopsies confirmed the diagnosis of metastatic cutaneous melanoma.
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