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All skin and subcutaneous masses should have FNA cytology performed as part of the diagnostic process before surgical intervention. Most skin masses are easily accessible and amenable to this cost‐effective procedure, which can provide a rapid diagnosis and differentiate benign from malignant disease in most cases. FNA cytology provides information on tumor type (e.g. round cell vs. epithelial vs. mesenchymal cell types), but often the specific cell of origin type or tumor grade cannot be determined because the cytomorphology is not distinctive and no tissue architecture information is available. Round cell and epithelial tumors tend to exfoliate better and are more likely to provide a diagnostic sample compared to mesenchymal tumors. For diagnosing cutaneous neoplasia, FNA cytology had a sensitivity of 89.3%, a specificity of 97.9%, a positive predictive value of 99.4%, and a negative predictive value of 68.7% compared to histology (Ghisleni et al. 2006). If cytologic evaluation of a cutaneous mass is not diagnostic or knowledge of the tumor grade will influence the surgical dose, an incisional or needle core biopsy is indicated to obtain enough tissue to determine the histologic tumor type and grade to determine appropriate treatment options.