The authors diagnosed a 54-year-old male as central mucoepidennoid carcinoma after undergoing clinical, radiological and histopathological examinations. The characteristics were as followed : 1. Clinically, the patient complained of the painless unilateral swelling of the left mandibular molar region and had a pus discharge through the fistula. Painful nodule was palpated on the scalp of the left frontal area and it was regarded as a metastatic lesion. 2. Plain radiographs showed the ill-defined permeative radiolucent lesion. The osteolytic lesions were also detected in the cranial bone, number 9 and 11 ribs, scapula, and vertebral bodies. 3. The mandibular CT and PNS MRI showed the swelling of the left mandible and the enlargement of the several lymph nodes of 1.5 cm in size. 4. Histopathologically, many solid epidermoid type cells were mixed with mucus-secreting cells and they were arranged in duct-like structure. Most of them were epidermoid type, which indicates a high grade tumor. Mucins could be found in mucicamrine staining.