Prostate carcinoma is the most common non-dermatological malignancy in men and only second to lung cancer as the leading cause of cancer related deaths in America. Moreover, metastasis to the skin is even more uncommon following apparently successful treatment of a preexisting prostate cancer. We present an 87-year-old man previously diagnosed with prostate cancer treated with brachytherapy, who presented with a metastatic prostate adenocarcinoma of the scalp mimicking a basal cell carcinoma. Herein, we present a patient with an NKX 3.1 positive cutaneous metastatic prostate carcinoma identified through NKX3.1 stain rather than the typical PSA/PSAP stain.