Metastatic prostate cancer recurrence after definitive local therapy can occur in any tissue. Usually, the first affected site is the bone. Lung metastases without bone or lymph node involvement are extremely rare in patients with prostate cancer, and only a handful of cases are reported in the literature. In several other malignancies, such as breast cancer, sarcomas, colorectal cancer, and renal cell carcinoma, long-term disease-free survival has been reported after resection of solitary pulmonary metastases.

We present three unusual cases of isolated pulmonary recurrence of prostate cancer after initial definitive local therapy. One of the patients underwent resection of the lung metastasis, resulting in a long-term disease-free survival.

Both surgical excision of solitary and oligometastatic lung secondary lesions and systemic therapy can play an important role in long term disease control. Surgery should be considered for selected and well-informed patients with pulmonary metastasis after primary localised treatment for prostate cancer.