Background: Metastases of malignant melanoma to the reproductive organs are occasionally encountered. They always represent a diagnostic challenge and they mimic various ovarian entities from primary ovarian malignancy to benign tumors.
Case: A 35-year-old woman presented with bilateral ovarian metastases which had clinical features of an acute state mimicking a tuboovarian abscess. The diagnosis was established postoperatively.
Conclusion: Sophisticated imaging methods may be necessary in cases of ovarian tumors in patients with a previous history of melanoma with possible metastatic dissemination. Urgent admittance and treatment of these patients with a range of clinical symptoms can be critical and may lead to a wrong diagnosis. Attentive monitoring of ovarian morphology in women with treated malignant melanoma is mandatory to detect rare but possible metastatic sites. Regardless of surgical and adjuvant therapy dissemination of malignant melanoma to the ovary has unfortunately a poor prognosis.