Scalp swellings are commonly seen in surgical practise. Hard swellings indicate bony origin with metastasis being more common than a primary bone pathology. Lung and breast cancer are the common primary malignancies in such cases. We review the literature on HCC as a source of skull metastasis and report a case of 45 year old man who presented with an isolated scalp swelling. CT scan showed a metastatic lesion in occipital region with osteolysis. Trucut biopsy was suggestive of adenocarcinoma but CT Chest, Abdomen and pelvis isolate the primary. Finally on PET CT, diagnosis of HCC was made and the patient who was being considered for definitive excision is now being given palliative chemotherapy.
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