Melanoma incidence is increasing and is associated with the majority of skin cancer-related deaths. Most melanomas have an indolent growth and are difficult to diagnose, attributing to their increased risk of metastatic disease on initial presentation. Nodular melanoma accounts for roughly 15% to 30% of all the melanomas, making it the second most common melanoma. This case describes nodular melanoma, the atypical presentation, the diagnosis, and the treatment. This case is of special interest due to the rarity of the disease and this particular patient's disease presentation and management. Unfortunately, the patient refused further surgery, so definitive treatment was not achieved.