Involvement of the gastrointestinal tract with malignant melanoma is a common entity in patients with advanced disease. In a study by Das Gupta and Brasfield,1more than 50% of patients with disseminated melanoma were found to have gastrointestinal involvement and 15% of patients had involvement of the gallbladder. In the largest series of patients from the Duke University Medical Center, Dong et al2reported that the average age at presentation of patients with melanoma involving the gallbladder was 46.7 years, 80% of patients were male, and 17 of 19 patients had known cutaneous primary tumors. The average depth of invasion of these primary lesions was 1.7 mm (range, 0.5-4.3 mm). As occurred in our patient, the symptoms of melanoma involving the gallbladder often mimicked those of acute or chronic cholecystitis (right upper quadrant or epigastric pain and tenderness); however, in some cases nonspecific abdominal complaints (weight loss, food intolerance, nausea, and vomiting) were reported. There have been case reports of patients with gallbladder melanoma presenting with obstructive jaundice when the tumor obstructs the common bile duct.3Imaging studies used to delineate the diagnosis include computed tomography, ultrasonography, and oral cholecystography. If the diagnosis is not suspected prior to imaging, however, the latter 2 studies are often misinterpreted as showing cholelithiasis or gallbladder polyps. The diagnosis is often made only after examination of a resected specimen that demonstrates single or multiple polypoid, pigmented tumors in the mucosa.