Background And Objectives: Malignant tumors occurring in the scalp are not common and when asymptomatic or small in size, may be covered by hair and neglected by the patient, leading to a potential risk of delay in detection and resulting in poorer outcomes.

Materials And Methods: In our Departments in the last five years more than 200 malignant tumors of the scalp have been operated on. In this article we take into consideration four rare malignant tumours of the scalp taken from this study: a giant recurrent sebaceous carcinoma, a lung cancer metastatic lesion, a malignant melanoma and a breast cancer metastasis.

Results: The four patients with rare malignant tumours have been operated with good results.

Discussion: These four cases represent an important lesson for the plastic surgeon to learn: in the case of the presence of unusual, ulcerated/pigmented lesion of the scalp or in the case of alopecia we must consider the possibility of a tumour.

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