Obstructive Ureteral Metastasis From Prostate Cancer
ABSTRACT Prostate cancer is the second most common malignancy in males, primarily associated with risk factors such as age, ethnicity, obesity, and family history. While metastases commonly involve lymph nodes, bones, and the liver, ureteral metastasis is exceedingly rare. Ureteral obstruction due t...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-08-01
|
| Series: | Clinical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ccr3.70753 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849229065414770688 |
|---|---|
| author | Ahmad Al‐Bitar Alaa Senjab Zeina Alhamwy MHD Ruchdi Al Attar Muhamad Al Tawil |
| author_facet | Ahmad Al‐Bitar Alaa Senjab Zeina Alhamwy MHD Ruchdi Al Attar Muhamad Al Tawil |
| author_sort | Ahmad Al‐Bitar |
| collection | DOAJ |
| description | ABSTRACT Prostate cancer is the second most common malignancy in males, primarily associated with risk factors such as age, ethnicity, obesity, and family history. While metastases commonly involve lymph nodes, bones, and the liver, ureteral metastasis is exceedingly rare. Ureteral obstruction due to metastatic prostate cancer can lead to hydronephrosis, often requiring ureteroscopy for diagnosis and management. However, persistent symptoms may necessitate exploratory surgery. An 82‐year‐old Arab male with a history of Gleason 4 + 4 = 8 prostate adenocarcinoma (initially managed with hormonal therapy and surgical castration) presented with right back pain. Imaging revealed stage 4 hydronephrosis, initially attributed to a ureteral stone. Ureteroscopy identified obstructing ureteral tumors instead, with biopsy confirming well‐differentiated adenocarcinoma of prostatic origin. Due to persistent obstruction and confirmed malignancy, a right nephroureterectomy was performed. Histopathology demonstrated extensive ureteral involvement (16 cm) with vascular and perineural invasion but no distant metastasis on postoperative PET‐CT. This case underscores the diagnostic challenge of ureteral metastasis in prostate cancer, often mimicking benign conditions like ureteral stones. Despite successful local surgical control, the tumor's aggressive features necessitate long‐term surveillance and continued hormonal therapy. High clinical suspicion for metastasis is crucial in high‐risk prostate cancer patients presenting with obstructive uropathy, even in the absence of significantly elevated PSA. This report highlights the importance of a stepwise diagnostic approach and the need for prompt intervention in such rare presentations. |
| format | Article |
| id | doaj-art-025fa17c62644b6bb7966a504e9fc0f4 |
| institution | Kabale University |
| issn | 2050-0904 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj-art-025fa17c62644b6bb7966a504e9fc0f42025-08-22T07:33:07ZengWileyClinical Case Reports2050-09042025-08-01138n/an/a10.1002/ccr3.70753Obstructive Ureteral Metastasis From Prostate CancerAhmad Al‐Bitar0Alaa Senjab1Zeina Alhamwy2MHD Ruchdi Al Attar3Muhamad Al Tawil4Faculty of Medicine Damascus University Damascus Syrian Arab RepublicFaculty of Medicine Damascus University Damascus Syrian Arab RepublicFaculty of Medicine Damascus University Damascus Syrian Arab RepublicFaculty of Medicine Damascus University Damascus Syrian Arab RepublicFaculty of Medicine Damascus University Damascus Syrian Arab RepublicABSTRACT Prostate cancer is the second most common malignancy in males, primarily associated with risk factors such as age, ethnicity, obesity, and family history. While metastases commonly involve lymph nodes, bones, and the liver, ureteral metastasis is exceedingly rare. Ureteral obstruction due to metastatic prostate cancer can lead to hydronephrosis, often requiring ureteroscopy for diagnosis and management. However, persistent symptoms may necessitate exploratory surgery. An 82‐year‐old Arab male with a history of Gleason 4 + 4 = 8 prostate adenocarcinoma (initially managed with hormonal therapy and surgical castration) presented with right back pain. Imaging revealed stage 4 hydronephrosis, initially attributed to a ureteral stone. Ureteroscopy identified obstructing ureteral tumors instead, with biopsy confirming well‐differentiated adenocarcinoma of prostatic origin. Due to persistent obstruction and confirmed malignancy, a right nephroureterectomy was performed. Histopathology demonstrated extensive ureteral involvement (16 cm) with vascular and perineural invasion but no distant metastasis on postoperative PET‐CT. This case underscores the diagnostic challenge of ureteral metastasis in prostate cancer, often mimicking benign conditions like ureteral stones. Despite successful local surgical control, the tumor's aggressive features necessitate long‐term surveillance and continued hormonal therapy. High clinical suspicion for metastasis is crucial in high‐risk prostate cancer patients presenting with obstructive uropathy, even in the absence of significantly elevated PSA. This report highlights the importance of a stepwise diagnostic approach and the need for prompt intervention in such rare presentations.https://doi.org/10.1002/ccr3.70753hydronephrosismetastasisprostate cancerureter stonesureteral metastasisureteral obstruction |
| spellingShingle | Ahmad Al‐Bitar Alaa Senjab Zeina Alhamwy MHD Ruchdi Al Attar Muhamad Al Tawil Obstructive Ureteral Metastasis From Prostate Cancer Clinical Case Reports hydronephrosis metastasis prostate cancer ureter stones ureteral metastasis ureteral obstruction |
| title | Obstructive Ureteral Metastasis From Prostate Cancer |
| title_full | Obstructive Ureteral Metastasis From Prostate Cancer |
| title_fullStr | Obstructive Ureteral Metastasis From Prostate Cancer |
| title_full_unstemmed | Obstructive Ureteral Metastasis From Prostate Cancer |
| title_short | Obstructive Ureteral Metastasis From Prostate Cancer |
| title_sort | obstructive ureteral metastasis from prostate cancer |
| topic | hydronephrosis metastasis prostate cancer ureter stones ureteral metastasis ureteral obstruction |
| url | https://doi.org/10.1002/ccr3.70753 |
| work_keys_str_mv | AT ahmadalbitar obstructiveureteralmetastasisfromprostatecancer AT alaasenjab obstructiveureteralmetastasisfromprostatecancer AT zeinaalhamwy obstructiveureteralmetastasisfromprostatecancer AT mhdruchdialattar obstructiveureteralmetastasisfromprostatecancer AT muhamadaltawil obstructiveureteralmetastasisfromprostatecancer |