[A case of carcinoma of the prostate presenting as abdominal mass]

A 69-year-old man was hospitalized for bilateral abdominal masses and constipation on October 31, 1986. Physical examination revealed firm, rough, movable, hard masses of over fist size, in the bilateral lower abdomen. CT scan disclosed two large masses in the pelvis. The prostate was of walnut size, rough and elastic firm on rectal examination. The serum acid phosphatase was elevated. Needle biopsy of the prostate and open biopsy of the mass showed a poor differentiated adenocarcinoma. Treatment with diethylstilbestrol diphosphate, 5-fluorouracil, estramustine sodium phosphate, chlormadinone acetate, 1-la-tetrahydrofuryl-5-fluorouracil, and cyclophosphamide was effective. The masses-metastasis of intrapelvic lymph nodes have shrunk and serum acid phosphatase has fallen to the normal level. In April 1987, the patient left hospital, and as of October 1987, he is still alive. This case indicates the presence of an unusual type of prostatic carcinoma in which huge lymph node metastasis occurs.