‘Factitious illness’ is a recently classified group of diseases characterized by repeated purposeful simulation of physical or mental illness in order to obtain medical or psychiatric treatment. ‘Münchausen Syndrome’ is a classical example of this group.

The case reported is a 26-year-old Caucasian male who presented with recurrent facial swelling between December 1978 and November 1987. His true condition eluded diagnosis for so long because he presented repeatedly with overt clinical signs which appeared severe enough to justify the symptoms claimed.

Primary mucosal melanomas of the upper aero-digestive tract are uncommon and represent only 1.7 to 3 per cent of all primary melanomas. The most frequent localization are the nasal fossae, the paranasal sinuses and the oral cavity where melanomas most often arise from the palate and alveolar ridge, buccal mucosa, lips, tongue and floor of mouth.

The authors describe a case of malignant melanoma of the uvula, review the literature and discuss the aetiology, pathology and diagnostic and therapeutic problems.