The findings were as follows.“The surgical specimen showed a lobular proliferation of tumour cells with glandular differentiation associated with a few mitotic cells, embedded in a mucinous stroma. Immunohistochemistry showed that the majority of tumour cells were positive for PAS diastase, toluidine blue, cytokeratins (CAM5.2, CK7), S-100 protein and GCDFP-15.”Although some abnormal tumours cells were present, the recorded findings the man was diagnosed with chondroid syringoma. An ultrasound and radiography were performed and revealed no indication of metastasis. However, in 2008, the man observed inflammation in his right groin area. Another ultrasound revealed a new mass also measuring 30 mm x 30mm, which was then excised. Examination of this new tumour revealed more abnormal tumour cells compared to the first nodule of the sole of the foot. The original diagnosis was thus re-examined to be consisting of malignant chondroid syringoma cells. The patient was then treated with radiation. After eighteen months he presented no evidence of recurrence or further distant metastasis. History
Hirsch and Helwig gave malignant chondroid syringoma its name in 1961 in ‘Chondroid Syringoma: Mixed Tumour of Skin, Salivary Gland Type.’ "Atypical mixed tumours of the skin,"(Hirsch and Helwig, 1961) their term for tumours characterised by "histological stigma of malignancy, local invasion, and satellite tumour nodules without proven metastases" is employed even now. As of 2011, only 43 cases have been reported. Terminology
Malignant mixed tumours also go by other names including: "malignant mixed tumour of skin, cutaneous malignant mixed tumour, metastasising chondroid syringoma, and aggressive chondroid syringoma."
The rare neoplasms generally do not follow a determinate development path and are often difficult to diagnose.Histologically, these malignant mixed tumours have epithelial and mesenchymal components and are very large, nodular, circumscribed, and nonulcerated. They are morphologically identical to pleomorphic adenoma and have a female predilection. They range from developing deep dermal to subcutaneous nodules and metastasise at a very high rate. Malignant mixed tumours can emerge "de nova or more rarely develop from a cartilaginous syringoma. "(IADVL, 2004)

Causes
Currently malignant mixed tumours do not have a definitive predisposing factor; however, prior physical injury has been proposed as a potential risk for the emergence of these tumours. Chondroid syringoma less than three centimetres are shown to have a heightened risk of malignancy. Other critical indicators include excessive mucoid matrix, – a connective tissue tumour with a myxoid background that is composed of "clear, mucoid substance – numerous mitoses, and poorly differentiated chondroid components." (Metzler, Schaumburg-Lever, Hornstein, and Rassner, 1996)

Diagnosis
Diagnosing malignant mixed tumours is difficult as there many types of tumours and their variants. Malignant chondroid syringoma is particularly challenging to distinguish from other skin tumours as it is prone to the absence of definitive symptoms and an ambiguous clinical presentation. Some signs that help determine diagnosis of malignancy include: "mitosis, nuclear atypia, pleomorphism, lymphatic invasion, and local recurrence" (IADVL, 2004). Though it is usually found within women in the forties, the youngest-recorded case was fourteen years old and the oldest was eighty-six.