Metastatic Prostate Adenocarcinoma with Rare Ureteral Metastases: A Case Report

Prostate adenocarcinoma is a major concern for many elderly men and while patients may be diagnosed without any symptoms and tolerate treatment well, we must consider other presentations as well.Prostate cancer that has spread to the ureter should be on the differential diagnosis in an elderly man with new onset flank pain and hydronephrosis.Because ordering a PSA is a screening tool for prostate cancer, it can easily be added to the workup in any patient presenting to the emergency department.If there is a ureteral mass on imaging with confirmed prostate cancer, there should be a biopsy of the ureteral mass to rule out urothelial carcinoma.If this can't be performed, a CT urogram and ureteroscopy can be very helpful in determining the cause of the mass.While cases of prostate cancer spreading to the ureter are very rare, detailed workups that catch the spread of the disease earlier can lead to better long-term patient outcomes.