Obstructive jaundice as the first clinical manifestation of a metastatic malignant melanoma in the ampulla of vater

The authors report a patient with obstructive jaundice as the first clinica l manifestation of a primary malignant melanoma metastatic in the ampulla o f Vater. After the histologic diagnosis of the metastases was made, the pri mary tumor was located in the skin of the back. Obstruction jaundice second ary to ampullary obstruction due to metastatic melanoma has only been repor ted twice, and in neither case was jaundice the first symptom of the diseas e.