To our knowledge, this is the first histologic report of vitelliform retinopathy in metastatic cutaneous melanoma. Although there was no clinical evidence of choroidal metastasis (fundus examination, fluorescein angiography, ultrasonography), the histopathologic findings confirm choroidal infiltration. Clinically, the patient had nyctalopia, which would be consistent with MAR, but electroretinography and antiretinal antibody testing were not performed. Previous cases of vitelliform retinopathy have had some clinical findings consistent with MAR,1,2,4,6 while others have not.4,5 None of these reports had clinical evidence of choroidal involvement. The vitelliform lesions have been postulated to represent a new paraneoplastic clinical manifestation. The pathologic results in this case argue against a paraneoplastic entity but may suggest a local metastatic cause with subclinical choroidal involvement. Another explanation is that choroidal involvement occurred after the vitelliform lesions with the dissemination of the metastatic melanoma. Further studies are needed to determine the etiology of these vitelliform lesions in metastatic melanoma.