en Supportive and Palliative Care Case Report and Series <div style="text-align: justify;"><span style="font-size:16px;"><span style="font-family:Times New Roman;"><strong>Introduction: </strong>Orbital metastasis of prostate cancer (PC) is very rare and even more unique in castration-resistant PC (CRPC). In this scenario, choline positron emission tomography/computed tomography (choline PET/CT) is the gold-standard restaging method of choice available in our setting, and new anti-androgens treatments show improvement in overall survival.<br> <strong>Case presentation: </strong>We report the case of a 69-year-old male patient diagnosed with PC, treated with radical prostatectomy, and salvage radiotherapy after biochemical recurrence. After new prostate-specific antigen (PSA) progression, androgen deprivation therapy (ADT) was started. Four and a half years later, and already labeled as non-metastatic CRPC with a negative extension study, including choline PET/CT, he developed an accidental left frontal head trauma, presenting with proptosis, palpebral oedema, and oculomotor disorder. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a destructive bone lesion in the left orbit, associated with a soft tissue mass. These findings, suggestive of a neoplastic lesion, were histologically confirmed PC metastasis. Treatment was initiated with abiraterone, with a rapid improvement of symptoms, a progressive decrease of PSA, and a significant radiological response.<br> <strong>Conclusion</strong>: Orbital metastases may present with proptosis and should be considered in patients with a history of cancer. If the ocular-orbital disease is suspected, the nuclear medicine physician should be aware that the choline PET/CT imaging includes the orbits. Tolerability and response to treatment with abiraterone were excellent.</span></span></div> Prostatic Neoplasms, Orbital Neoplasms, Neoplasm Metastasis 1 4 http://mcijournal.com/browse.php?a_code=A-10-363-1&slc_lang=en&sid=1 Sonia García-Cabezas songar1@gmail.com 10031947532846002704 10031947532846002704 No Department of Radiation Oncology, Reina Sofia University Hospital, Cordoba, Spain María del Carmen Moreno-Manzanaro Moreno morenomanzanaroma@gmail.com 10031947532846002705 10031947532846002705 No Department of Radiation Oncology, Reina Sofia University Hospital, Cordoba, Spain Amalia Palacios-Eito amalia.palacios.sspa@juntadeandalucia.es 10031947532846002706 10031947532846002706 Yes Department of Radiation Oncology, Reina Sofia University Hospital, Cordoba, Spain