Metastatic tumors of the hypothalamic-pituitary region are uncommon. The majority of metastases in this area are silent lesions incidentally discovered at autopsy. Breast carcinoma in women and lung and prostate carcinoma in men are the most common primary tumors. Symptomatic metastases from esophageal adenocarcinoma are very rare. We describe the case of a 47-year-old man with an adenocarcinoma of the esophagus, who developed panhypopituitarism, diabetes insipidus, and symptoms secondary to metastatic infiltration of the hypothalamic-pituitary region. The unusual primary tumor and clinical presentation make this case very interesting. Clinical presentation, diagnosis, and therapeutic management of hypothalamic-pituitary metastases are reviewed.