[A case of prostatic carcinoma presenting as abdominal mass]

A 69-year-old man was admitted to the hospital on August 7, 1991 because of a lower abdominal mass. On physical examination, firm, rough-surfaced, unmovable masses of over fist size were palpable in the lower abdomen along with some small masses in the bilateral inguinal regions. On rectal examination the prostate was rough, hard and stony and larger than a chicken's egg in size. The serum prostatic acid phosphatase and prostatic specific antigen levels were elevated. A computerized tomography scan disclosed a large mass in the pelvis. Both a needle biopsy of the prostate and resection of an inguinal mass revealed moderately differentiated adenocarcinoma. Bone scintigram disclosed multiple metastases. Treatment with diethylstilbestrol diphosphate, etoposide, peplomycin and ifosfamide was effective, resulting in regressed intrapelvic masses and decreased serum prostatic acid phosphatase and prostatic specific antigen levels close to the normal limits. In November 1991, the patient was discharged and was surviving with the tumor as of August 1992.