Ureteric stricture: an unusual presentation of metastatic prostate adenocarcinoma

• Published in: Annals of the Royal College of Surgeons of England Vol. 94; no. 7; pp. e213 - e7
• Main Authors: Jallad, S, Turo, R, Kimuli, M, Smith, J, Jain, S
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01-10-2012; Royal College of Surgeons
• Subjects: Adenocarcinoma - complications; Adenocarcinoma - pathology; Aged; Humans; Lymphatic system; Male; Metastasis; Online Case Report; Prostate cancer; Prostatic Neoplasms - complications; Prostatic Neoplasms - pathology; Ureteral Neoplasms - secondary; Ureteral Obstruction - etiology; United Kingdom > UK
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/003588412X13373405385971

We describe an unusual case of a prostatic adenocarcinoma presenting with a ureteric stricture secondary to a discrete metastatic lesion. A 76-year-old man presented with a short history of right loin pain. Initial examination was unremarkable, digital rectal examination was normal and prostate specific antigen was within normal range. Computed tomography showed right hydronephrosis and a distal ureteric stricture. A distal ureteric transitional cell carcinoma was thought to be most likely. A nephroureterectomy was carried out and histology revealed a skipped lesion of a metastatic prostate adenocarcinoma. Metastatic lesions to the ureters due to prostate cancer are rare. It was believed to be secondary to a transitional cell carcinoma as there was no evidence initially to suggest prostatic disease as the cause. A prostatic adenocarcinoma should be considered in the differential diagnosis of any lesions in the ureter believed to have a malignant origin.