Background: Magnetic resonance imaging (MRI) and MR spectroscopic imaging (MRSI) have been gaining acceptance as tools in the evaluation of prostate cancer. We compared the accuracy of transrectal ultrasound (TRUS)-guided biopsy and dynamic contrast-enhanced MRI combined with three-dimensional (3D) MRSI in locating prostate tumours and determined the influence of prostate weight on MRI accuracy. Patients and Methods: Between March 1999 and October 2006, 507 patients with localised prostate cancer underwent radical prostatectomy (RP) at the Jules Bordet Institute. Of these, 220 had undergone endorectal MRI (1.5 T Siemens Quantum Symphony) and 3D-MRSI prior to RP. We retrospectively reviewed data on tumour location and compared the results obtained by MRI and by TRUS-guided biopsy with those obtained on histopathology of the RP specimen. Results: Patient data were as follows: median age 62.4 years (45–74); median PSA 6.36 ng/ml (0.5–22.6); 73.6% of patients had non-palpable disease (T1c); median biopsy Gleason score 6 (3–9); median RP specimen weight 50 g (12–172); median pathological Gleason score 7 (4–10); 68.64% of patients had organ-confined (pT2) disease. Tumour localisation was correlated with RP data in a significantly higher percentage of patients when using MRI rather than TRUS-guided biopsy (47.4 vs. 36.6%, p < 0.0001). MRI was marginally superior to TRUS-guided biopsy in detecting malignancy at the prostate apex (48.3 vs. 41.9%, p = 0.0687) and somewhat better at the prostate base (46 vs. 39.1%, p = 0.0413). It was highly significantly better at mid-gland (52 vs. 41.1%, p = 0.0015) and in the transition zone (40.1 vs. 24.3%, p < 0.0001). MRI had higher sensitivity in larger (≧50 g) than smaller (<50 g) prostates (50.3 vs. 42.2%, p = 0.0017). Conclusions: MRI was superior to TRUS-guided biopsy in locating prostate tumours except at the gland apex. MRI was more accurate in larger (≧50 g) than smaller prostates.

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Background: Cutaneous metastases from colorectal cancer are uncommon, accounting for 6.5% of all secondary skin lesions. They occur in advanced disease. The most common site is the abdomen. The penis is a rare site. Case Report: We report the case of a 79-year-old patient who presented, two years after rectocolectomy for a rectal adenocarcinoma, obstructive renal failure secondary to a presacral recurrence, as well as symptomatic phimosis associated with papulonodules invading the penis, scrotum and pubis. After hemodialysis, percutaneous pyelostomy, and double-J catheter placement, the patient underwent circumcision and a pubic skin biopsy. On histology and immunohistochemistry, a cutaneous metastasis originating from the rectal adenocarcinoma was diagnosed. Conclusions: Penile invasion by colorectal cancer revealed by phimosis is a rare occurrence but needs to be recognized and promptly diagnosed by biopsy in order to propose appropriate adjuvant therapy. These rare lesions can occur without any liver or lung involvement.

Recent studies have demonstrated an association between higher body mass index and increased aggressiveness in prostate cancer. The present narrative review, based on a search of Medline® and Embase® databases from October 1982 to October 2012, explores the relationship between higher body mass index and localized prostate cancer. In particular, the current epidemiological and mechanistic evidence for interactions between obesity and prostate cancer are discussed. Obesity is associated with alterations in androgen levels, decreased sex hormone binding globulin and increased estrogen levels, insulin resistance, hyperglycemia, alterations in plasma lipoprotein levels particularly raised triglycerides and reduced high density lipoprotein, decreased levels of adiponectin, and increased levels of circulating insulin-growth factor- 1, leptin and dietary saturated fats. Obese men have more aggressive prostate cancer with a greater percentage prostate involvement, increased tumor volume and higher-grade disease, enlarged prostates, high prostate-specific antigen levels, increased risk of having positive margins and recurrence. Moreover, there is strong evidence of the beneficial effects of functional foods for the treatment of obesity. Additionally, an increasing number of studies support that obesity-induced inflammation plays an important role in the development of obesity-related pathologies. Despite, the beneficial role of nutriment in prostate cancer control, the use of functional foods in prostate cancer is not recommended for lack of large epidemiological studies. This data supports the hypothesis that obese men have more aggressive prostate cancers and that the obesity is a modifiable risk factor of prostate cancer. Key Words: prostate cancer, metabolic syndrome, obesity, high BMI, risk factor, diet, functional foods.

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