Distant ureteric metastasis of prostate cancer four years post radical prostatectomy

We describe a case of a 78-year-old male with a history of Gleason score 9 prostate cancer treated with a robotic-assisted radical prostatectomy, who developed symptoms of right ureteric obstruction four years later. Diagnostic evaluation revealed right sided hydroureteronephrosis on imaging. Further correlation with prostate specific antigen (PSA) and histopathology from a distal ureterectomy with reimplantation revealed metastatic prostate cancer as the cause of obstruction with incidental focal carcinoma in situ (CIS) also identified. This case highlights the diagnostic challenges and management strategies for ureteric metastasis of prostate cancer and contributes to the limited body of literature on such cases.