Acanthosis nigricans (AN) is characterized by hyperpigmented, thickened skin plaques with a velvety texture. The histology of these lesions shows hyperkeratosis and dermal papillomatosis. According to the clinical data the key role in the development of acanthosis nigricans belongs to an excessive concentration of growth factors. Such condition is ofparticular interest because of its association with internal malignancies. Its malignant form is often associated with gastric adenocarcinoma (55-61%), though coexistence with a variety of other malignancies (ovarian cancer, endometrial carcinoma, bladder cancer, etc.) has been reported. Clinical case of patient with AN and coexisting breast cancer and hepatocellular carcinoma is presented. The severity of skin manifestations improved after chemotherapy, mastectomy and radiation therapy. However, skin hyperpigmentation relapsed after development of the hepatocellular carcinoma and the progression of the primary tumor. An underlying malignancy should be suspected in each case of AN.