Background: The differential diagnosis of a patient presenting for the first time with iron deficiency anemia is usually wide and may require a whole series of investigations. We present one such case in
which her past history provided the clue to an unusual diagnosis.Case Report: A 66yr old lady presented to the outpatients with five weeks history of lower abdominal pain, anorexia and weight loss. Her Hematology showed iron deficiency anemia. She had melanoma of the back removed three years ago and melanoma of the eye removed twenty years ago. She was faecal occult blood positive. Further investigations showed that she had a large single metastasis from malignant melanoma in the hepatic flexure with no involvement of the rest of the bowel and no abdominal adenopathy. She had a right hemicolectomy andwas referred to a tertiary centre for melanoma vaccine.Conclusions: Metastasis from malignant melanoma may involve organs and present with symptoms, many years after the removal of the primary lesion.

Keywords: malignant melanoma, colonic tumor, metastasis