Metachronous metastasis of renal cell carcinoma to the contralateral ureter 8 years after nephrectomy presenting as hydronephrosis

Renal cell carcinoma (RCC) is characterized by a potential for unpredictable metastatic pattern and a capacity for delayed recurrence years after apparently curative surgical resection. Metastatic spread most commonly involves the lungs, bone, and lymph nodes, and involvement of the contralateral ureter is exceptionally rare, particularly when occurring as a true metachronous lesion years after primary tumor resection. Herein, we report a case of isolated contralateral distal ureteral metastasis identified 8 years after radical nephrectomy for RCC.