Metastasis to the skin from carcinoma arising in other organs is uncommon, yet it may be the first presentation of neoplastic disease. The incidence of esophageal adenocarcinoma has been rapidly rising and now accounts for at least half of esophageal carcinomas. Cutaneous metastases of esophageal adenocarcinoma are extremely rare; less than 1 % of patients with metastatic disease have cutaneous involvement. We reported a rare cutaneous cheek metastasis from an adenocarcinoma in an 81-year-old white man, who was excised, and the defect repaired with a reverse cervicofacial flap. Subsequent investigations, based on the result of the pathological anatomy, detected the primary tumor in the esophagus, despite no symptoms. Although cancer of internal organs rarely presents with skin metastases, any suspicious lesions with rapid growth should be ruled out as their metastatic origin. We reported a case and reviewed the clinical characteristics of the few patients reported on the literature. Level of Evidence: Level V, diagnostic study