Recurrence in colorectal cancer after surgical resection is common. The most common sites of recurrence are local recurrence, the liver, the lung, and the peritoneum. We present the rare case of a 57-year-old woman with rectal cancer who had undergone a radical proctectomy about 5 years earlier. Solitary recurrence in a right pulmonary hilar lymph node was detected on her follow-up F-18 FDG PET/CT. A pathology report confirmed a metastatic adenocarcinoma of colorectal origin.