Background:Mucoepidermoid carcinoma (MEC) is a malignant salivary gland neoplasm with extreme morphologic heterogeneity and hence rendering a definitive fine needle aspiration cytology (FNAC) diagnosis of this neoplasm is really challenging. The present study was undertaken to elucidate the cytological features of MEC and explore the diagnostic accuracy and pitfalls by comparing with subsequent histopathology.Materials and Methods:The present study was conducted over a period of 2 years wherein we obtained six histopathologically confirmed cases of MEC. These patients were initially subjected to FNAC. The cytologic features studied included presence of mucous cells, intermediate cells, and squamous cells. Presence of background mucinous material was also noted. The cytological features were compared with the subsequent histopathology.Results:Of the 6 cases of MEC, a definite cytological diagnosis was possible only in 2 cases. Of the remaining 4 cases, 2 cases were broadly diagnosed in cytology as neoplasm with cystic degeneration and 2 cases were underdiagnosed as pleomorphic adenoma.Conclusions:A satisfactory aspirate with all three types of cells; mucous, intermediate and squamous cells may not be obtained in all cases of MEC for providing a definite diagnosis. Hence, a good clinicoradiological correlation, a high index of suspicion and repeated aspirations especially in cystic lesions may be particularly helpful in difficult cases. In addition, while dealing with mucinous cystic lesions with low cellularity, the importance of early excision should be communicated to the clinician since the possibility of low-grade MEC cannot be excluded.

<p class="abstract"><span lang="EN-US">Follicular cancer is the second commonest form of differentiated thyroid malignancy. Unlike papillary cancer which has a predilection for lymph node metastases, it spreads more often by the hematological route. Even when they have spread to various organs, differentiated thyroid cancers have excellent prognosis if they can be resected completely. One of the presentation of metastases from follicular cancer is with pulsatile skull metastases. Here, we are reporting the clinical details of an elderly lady who presented with a swelling in the skull of 1 month duration. She had an otherwise asymptomatic thyroid swelling of 18 years duration also. Radiology revealed a lytic lesion on the skull. Cytological confirmation was done to diagnose follicular cancer with skull bone metastasis. After total thyroidectomy surgery, she was sent for radio-active iodine ablation and levothyroxine suppression. We are presenting this case as it is not a common form of presentation of this disease.</span></p>