Two Cases of Bilateral Ureteral Metastases From Prostate Cancer Initially Presenting With Postrenal Acute Kidney Injury

Introduction Although prostate‐specific antigen (PSA) screening has facilitated early detection of prostate cancer, approximately 5% of patients still present with distant metastases at diagnosis. Ureteral metastasis from prostate cancer is extremely rare. Case Presentation We report two cases of clinically diagnosed bilateral ureteral metastases in which postrenal acute kidney injury caused by bilateral hydronephrosis preceded the diagnosis of prostate cancer. Histopathological confirmation by ureteroscopic biopsy was not possible in either case. However, marked improvement in ureteral obstruction following initiation of androgen deprivation therapy supported the diagnosis. Conclusion Bilateral ureteral metastases from prostate cancer may present with acute kidney injury, and therapeutic response to androgen deprivation therapy may provide an important diagnostic clue when pathological confirmation is difficult.