Proximal Ureteral Metastasis from a Poorly Differentiated Prostatic Adenocarcinoma: A Case Report

Ureteral metastasis from prostate cancer is exceedingly rare and may mimic primary upper tract urothelial carcinoma, representing a major diagnostic pitfall. We report a 72-year-old man presenting with right flank pain and ureterohydronephrosis. Imaging revealed a proximal ureteral mass with a suspicious para-aortic lymph node, leading to nephroureterectomy. Histopathology demonstrated a grade group 5 prostatic adenocarcinoma, confirmed by subsequent prostate biopsies. Bone scintigraphy later revealed multiple metastases. The patient received combined hormonal therapy and chemotherapy. This case emphasizes the importance of histopathological confirmation and awareness of rare metastatic patterns to guide appropriate management.