A case of prostate cancer presenting as a symptomatic abdominal mass

Abstract

80歳男, 腹部腫瘤を主訴に受診.右下腹部に手拳大の硬い腫瘤が触知された.前立腺及び腹部腫瘤の針生検を施行, 病理学的診断は中分化型前立腺癌であった.胸部レントゲン写真では多発性の肺転移を認め, 臨床診断は前立腺癌(cT3N3M1, stageD2)であった.抗アンドロゲン療法開始から3ヵ月目で血中PSA値は正常範囲内まで減少し, 多発性肺転移は11ヵ月目で消失した.約30ヵ月の経過観察で腹部腫瘤はまだ認められるが, その大きさは治療前の1/4まで減少した

An 80-year-old man presented to our hospital complaining of an abdominal mass. On physical examination, a hard fist-sized mass was noted in the right lower abdomen. Needle biopsy of the prostate and abdominal mass showed moderately differentiated adenocarcinoma. The chest roentgenogram revealed multiple lung metastases. Clinical diagnosis was T3N3M1, stage D2. Serum prostate specific antigen (PSA) level (8, 600 ng/ml) normalized after 3 months of anti-androgen therapy. Lung metastases disappeared after 11 months, while the abdominal mass was reduced to 25% of the pretreatment size after followup of 30 months.