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INTRODUCTION: Sarcopenia is a syndrome characterized by the loss of muscle mass and strength. The study objective was to determine the association between muscle density and overall survival (OS) in patients with metastatic onset prostate cancer (MPCa). MATERIALS AND METHODS: This was a retrospective study of patients diagnosed with MPCa between 2009 and 2015 who received androgen deprivation therapy alone as initial treatment. Muscle density was calculated using the Hounsfield Unit Average Calculation (HUAC) in both psoas muscles in the computed tomography (CT) scan performed for diagnosis. RESULTS: A total of 59 patients diagnosed with MPCa, with a mean age of 57.5±72.47 years, were found. Median prostate-specific antigen (PSA) level at diagnosis was 68.25 ng/dL (IQR 37.26-290). Gleason scores≥8 were recorded in 90.75% of the patients, bone metastases in 88.13%, and visceral metastases in 10.16%. Median HUAC was 20.32 HU (IQR 15.46-22.83). In a univariate analysis, the number of bone metastases, the presence of visceral metastases, and testosterone levels≥50 ng/dL at follow-up were associated with poorer OS, while high HUAC levels were associated with better OS. In a multivariate analysis, the number of bone metastases [hazard ratio (HR)=1.573, 95% confidence interval (CI)=1.103-2.243, p=0.012], the presence of visceral metastases (HR=7.404, CI=2.233-24.549, p=0.001), and the Gleason score (HR=2.001, CI=1.02-3.923, p=0.044) were associated with greater overall mortality, and HUAC (HR=0.902, CI=0.835-0.973, p=0.008) was associated with better OS. CONCLUSIONS: In our series, increased HUAC values in the psoas muscles, as a reflection of muscle density, when MPCa was diagnosed had a protective effect on OS in these patients.
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El aumento de tamaño escrotal acompañado de inflamación y dolor es una consulta frecuente en la práctica clínica habitual. Sin embargo, existen causas extraurológicas capaces de mimetizar dicho cuadro que deben ser incluidas en el diagnóstico diferencial. La etiología pancreática en estos casos es inusual, con poco más de 30 casos descritos en la literatura, y puede conducir a un diagnóstico y tratamientos equivocados. Presentamos el caso de un varón de 62 años que fue ingresado por una pancreatitis aguda, comenzando un mes después con un aumento del tamaño escrotal derecho que se trató de forma conservadora (AU)
Scrotal swelling, soreness and tenderness is a common consultation in ordinary clinical practice. However, extra urological causes are able to mimic this situation which should be included in the differential diagnoses. Pancreatic etiology in these cases is unusual, with few more than 30 cases described in the literature, which could lead to a wrong diagnosis and treatment. We aim to present a 62-year-old male patient who was admitted with acute pancreatitis, developing within a month a right scrotal swelling, treated conservatively (AU)