Cutaneous malakoplakia with verruciform xanthoma in the same lesion

occur (Table 2). The field cancerization theory would be considered the most likely in our case. The concept is that in an area vulnerable to a repeated carcinogenic insult (e.g. ultraviolet radiation), there is an elevated risk of neoplastic evolution in multiple cell lineages within the same lesion. Treatment for combined tumours is primary excision. Further management and prognosis is dependent on the more advanced of the two tumours. Despite relatively thick MM Breslow depths (1.0–6.0 mm), mortality has rarely been reported. Unexpectedly, bi-malignant tumours do not seem to be more aggressive than their monophasic counterparts. Amin et al. found a low rate of metastases and adverse events despite high Breslow thickness. In our case, the patient underwent radiological staging, which did not show any metastasis. The current classifications of these tumours are a high-risk SCC and Stage IICMM (according to the eighth edition of the American Joint Committee on Cancer staging manual). The patient continues to attend for skin cancer surveillance.