Metastasis of prostate cancer to renal pelvis is extremely rare. A 64-year-old man was hospitalized for increased prostate-specific antigen after radical prostatectomy. 68Ga-PSMA-11 PET/CT showed hydronephrosis caused by a mass in the left renal pelvis without significant uptake of prostate-specific membrane antigen tracer. The histopathology indicated metastatic prostate cancer with a Gleason score of 5 + 5 but negative for prostate-specific membrane antigen following nephroureterectomy. Although metastasis to renal pelvis is rare, the occurrence possibility could not be ignored when with hydronephrosis is found in prostate cancer patients.
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