[Adult respiratory distress syndrome in extensive intra-alveolar metastasis of an amelanotic malignant melanoma].

The case is reported of a 26-year-old patient hospitalized after 6 days of coughing and dyspnea with the clinical picture of "adult respiratory distress syndrome" (ARDS). In spite of intensive therapeutic efforts, death ensued within a few weeks. Autopsy revealed widespread intraalveolar metastases of a hitherto unrecognized amelanotic malignant melanoma of the back. Further metastases were only detected in intrathoracic lymph nodes and in the myocardium. A possible relationship between this unusual pattern of metastasis and previous abuse of nicotine, alcohol and hashish, as well as coexisting hypogammaglobulinemia, is discussed. It appears that widespread intrapulmonary metastasis must be considered one of the possible causes of ARDS.