BackgroundDistant Metastases from Head and Neck Squamous cell carcinomas are uncommon (9–11%) and they are usually found in the lung and less frequently in the liver, kidney and adrenals.Central nervous system (CNS) metastases are extremely rare (2–8%), and they are described mainly in patients who already have extracranial metastases. So there’s scarcity of data about their optimal management .Methods and resultsA patient presented CNS metastases after having been successfully treated with induction chemotherapy and definitive radiotherapy for a pyriform sinus carcinoma. The patient’s work up, treatment and outcome are described.ConclusionsCNS metastases from Head and Neck carcinomas are exceptionally rare. Nevertheless, clinicians should be alert of neurological symptoms in these patients, in order to set up a timely assessment and treatment. Secondarily, given the rarity of this condition, additional research on this topic is warranted in order to improve therapeutic strategies and outcomes of such patients.