Background: Malignant Proliferating Trichilemmal Tumor is very rare malignant tumors of hair follicles derived from outer root sheath. This tumor is mostly located on the head and neck of elderly women. Regional or distant metastasis is possible. In this study we present clinical features and treatment outcomes of cases diagnosed as Malignant Proliferating Trichilemmal Tumor. Also we aimed to emphasize a different clinical form of the tumor that can be misdiagnosed clinically. Patients & Methods: A retrospective evaluation of 5 cases operated between September 2009 and September 2017 at Celal Bayar University, Faculty of Medicine were included to the study. Clinicopathological features of patients, type of surgery and follow up information were evaluated. Results: Four patients were female. Average age was 72,20. All of the lesions were located on the head and neck. All patients had a history of rapid growth of lesions. Patients were scanned with computed tomography. There was no metastasis at the time of diagnosis. None of the patients needed adjuvant therapy. Mean follow up time was 11,8 months. None of the patients developed recurrence or metastasis. Conclusions: These tumors resemble basal cell or squamous cell carcinoma. Rapid progress of benign form of the tumor should adress malignant transformation. Regional or distant metastasis could be seen. There is no consensus about adjuvant therapy. Screening for metastasis and close follow up are mandatory.