As part of their physiological functions macrophages secrete various products that influence tissue environment. They can also secrete tumour growth promoting substances and it is highly probable that they help to establish tumour supporting fibrovascular stroma. Macrophages may fuse with other cells (including neoplastic cells) and many malignant properties of these hybrids or of their progeny may be maintained by the macrophage genome. In addition processes that occur after fusion might be important in inducing malignant transformation, especially when fusion has occurred with initiated cells. Superficial spreading melanoma is an example that is in keeping with the hypothesis of cell fusion.