(1) Background: Secondary tumors of the hyoid bone are extremely rare in clinics. In the literature, there is only one study about hyoid bone metastases from sigmoid adenocarcinoma. (2) Methods: We report a case of hyoid bone metastases in a 78-year-old patient treated for rectum and sigmoid colon adenocarcinoma. (3) Results: A mass excision surgery of a rounded osteolytic mass of 4.5 × 3.6 cm in size in the central part of the hyoid bone was performed under general anesthesia, according to the multidisciplinary tumor board recommendation. (4) Conclusions: Hyoid bone metastases can occur in the rectum and sigmoid colon adenocarcinoma. A total body bone scintigraphy and CT examination are suggested to detect silent bone metastases in patients with a history of cancer and neck masses. The prognosis is good, but a regular follow-up is recommended.
