A 55-year-old man sought medical attention because of the right flank pain. He was anemic with impaired renal function and was admitted to the hospital. Computer tomography demonstrated bilateral hydronephrosis due to ureteral obstruction. Biopsy of both ureters and immunohistochemical staining led to the final diagnosis of gastric carcinoma metastasizing to both ureters. This article presented a case in which metastases of the ureters were the first and sole presentation of gastric cancer.
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