ABSTRACT: INTRODUCTION: Melanoma is responsible for 1% to 2% of all cancer deaths around the world. Nodular melanoma often carries a poor prognosis because of no prodromal radial growth phase, early distant metastasis and significant tumor volume. CASE PRESENTATION: We present a case of progressive melanoma. A 51-year-old man was admitted to our hospital with dyspnea and skin lesions. These were multiple, dark colored, firm, and nodular and varied in size. He was diagnosed with melanoma. Temozolomide was administered, but he died of respiratory failure within a week after diagnosis. CONCLUSION: Nodular melanoma tends to spread rapidly and eventually metastasize to vital organs. It may be fatal within months of recognition.