Neuroendocrine prostate cancer (NEPC) is a rare and aggressive type of prostate cancer that often spreads in an atypical manner and has a poor prognosis[1]. Brain metastases from this type of tumor are exceptional and may present diagnostic problems[1]. In the presented case of a 59-year-old man, the initial ultrasound biopsy was diagnosed as poorly differentiated adenocarcinoma[1]. Whole-body PET/CT with [18F]fluorocholine revealed small hypermetabolic foci in the brain – specifically in the left frontal and temporal cortex and in the cerebellar hemisphere, which were suggestive of brain metastases[1]. An enlarged lymph node in the pelvis was also found without bone or other internal organ involvement[1]. Subsequent re-evaluation of the biopsy with extended immunohistochemical analysis confirmed the neuroendocrine (small cell) component of the tumor[1]. The patient was treated with stereotactic radiotherapy of brain lesions and localized radiotherapy of the primary prostate tumor[1]. This case highlights the importance of [18F]fluorocholine PET/CT in detecting unexpected metastases in neuroendocrine prostate cancer and the need for molecular imaging in aggressive types of prostate cancer[1].