DOI: https://doi.org/10.36347/sjmcr.2026.v14i05.009

Pages: 903-905

Background: Primary hepatic malignant melanoma is a rare clinical entity, with few reported cases and an unclear pathogenesis. Diagnosis remains challenging due to its nonspecific clinical presentation and radiological appearance that can mimic other malignant hepatic tumors. Case Presentation: We report a case of a 61-year-old North African male presenting with a 4-month history of abdominal pain, anorexia, and weight loss. Imaging revealed two hepatic lesions in segments V–VIII and III, characterized by heterogeneous enhancement and necrosis. Liver function tests and tumor markers [AFP, CEA, CA19-9] were within normal limits. Histological evaluation of core biopsies identified malignant cells with abundant intracytoplasmic melanin pigment. Immunohistochemistry demonstrated strong expression of MelanA, confirming melanoma. A comprehensive clinical, radiological, and laboratory workup excluded any other primary site, leading to the final diagnosis of primary hepatic melanoma. The patient was referred for systemic chemotherapy and continues to be followed. Conclusion: Primary hepatic melanoma is an exceptionally rare malignancy with no established treatment guidelines. Accurate diagnosis requires thorough exclusion of other primary sites and relies heavily on histopathological and immunohistochemical findings. Increased awareness is crucial for timely recognition and management of this rare tumor.