A 39-year-old man, who had been under observation for Acinic Cell Carcinoma of the parotid gland 4 years prior, he underwent a right parotidectomy. Initial oncologic management conducted multiple treatment cycles with several chemotherapeutic agents over the course of 03 years. Presented with a rapidly enlarging, tender and asymptomatic retro auricular nodule. Clinical examination revealed a smooth mass measuring 70 mm×60 mm in preauricular right region, it was, firm without signs of tenderness, and an erythematous slightly elevated nodule on the right mastoid area, sharply demarcated, with a surface covered by hemorrhagic crusts, and crater-like appearance (Figure 1) On dermoscopy: Peripheral arborescent vessels; white structureless area were seen (Figure 2). Given the dubious appearance, whether it is a keratoacanthoma or a cutaneous metastasis, a punch biopsy was indicated, and the diagnosis of acinic cell carcinoma metastatic to the skin was established. Due to the tumor progression, the patient was considered eligible for radiotherapy.