Carcinoma of prostate in clinically benign enlarged gland.

BACKGROUND Carcinoma of the prostate is one of the common tumours of old age in men. This cross sectional study was conducted to detect carcinoma of prostate in clinically benign enlarged gland and to evaluate the efficacy of Digital rectal Examination in detection of prostatic cancer in patients presented at Khyber Teaching Hospital, Peshawar from July 1998 to July 1999. METHODS Patients presenting with lower urinary tract symptoms over the age of 50 years were evaluated on English version of International Prostate Symptoms Score (IPSS), clinically examined and post-voiding residual urine determined on abdominal sonography. The selection criteria were; Severe IPSS, absence of signs of malignancy on Digital Rectal Examination (DRE) and post-voiding residual urine more than 100 ml. Thus a total 100 patients were selected for further study. Four ml blood was taken to assess Prostate Specific Antigen (PSA) level pre-operatively. All these patients underwent either transvesical prostatectomy or transurethral resection of prostate (TURP) and enucleated prostatic tissues were sent to histopathology. RESULTS Eighty-five percent patients had PSA level up to 10 etag/ml. PSA level of 15 (15%) patients were above 10n gm/ml out of which 13 (13%) patients were having PSA in range of 11-12 etag/ml and two (2%) had PSA level between 20-25 etag/ml. Histopathology report of 2% patients turned out as adenocarcinoma of the prostate. CONCLUSION Out of 100 patients who were having clinically benign DRE findings, 2 turned out as Carcinoma of the prostate histologically.