A large pigmented lesion mimicking malignant melanoma.

An 88-year-old woman was admitted with a huge bilateral pulmonary embolism and acute renal failure. On physical examination, a well-defined irregularly pigmented plaque 20 · 40 mm with black, brown and pink hues and an irregular border was noticed over the umbilicus (Fig. 1). A clinical diagnosis of malignant melanoma (MM) was suggested, and surgical excision planned. However, the patient’s prognosis was poor; she was very dyspnoeic, with oxygen saturation levels of < 75%, despite the treatment for pulmonary embolism, thus we chose to perform a biopsy to confirm the diagnosis, with the intention to proceed to treatment once the patient recovered from the embolism.