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Melanoma may mimic a variety of skin lesions clinically and histopathologically, and presents diagnostic challenges. In this article, we describe a case of melanoma in an 89-year-old man with a very rare histopathologic presentation, namely the presence of pleomorphic and multinucleated giant cells with abundant cytoplasm, highly resembling an atypical fibroxanthoma. The differential diagnoses in conjunction with the findings in immunohistochemical study are also discussed.Balancing allocation of assigning units to two treatment groups