Patients undergoing percutaneous endoscopic gastrostomy (PEG) for pharyngoesophageal malignancies are subject to develop malignant seeding at the PEG stoma. Risk factors include an untreated or recurrent advanced stage squamous cell carcinoma at the time of the PEG procedure and an endoscopic pull-string gastrostomy. Diagnosis is frequently late because this rare complication is poorly known. Prognosis remains poor despite aggressive treatment. Physicians should be aware of this complication in the event of hypermetabolic uptake around or close to a PEG stoma in patients monitored for a pharyngoesophageal squamous cell carcinoma.