Zinner’s syndrome, radiological diagnosis for a rare syndrome with non-specific clinical presentation: case report

• Main Authors: Ahmed Atef Soliman, Anwar Ali Alshukami, Walaa Hussein AlZuber
• Format: Article
• Language: English
• Published: SpringerOpen 2020-10-01
• Series: The Egyptian Journal of Radiology and Nuclear Medicine
• Subjects: Zinner’s syndrome case report; Seminal vesicle cystic lesion; Unilateral renal agenesis; Ejaculatory duct obstruction
• Online Access: http://link.springer.com/article/10.1186/s43055-020-00336-6

Abstract Background Zinner’s syndrome is a rare congenital malformation involving the seminal vesicle that mostly shows cystic transformation. Embryogenesis of the kidney, ureter, seminal vesicle, and vas deferens can be altered if an insult occurs during the first trimester mainly between the 4th and the 13th gestational week. Cystic lesions of the seminal vesicle may present with a mass effect. Associated ipsilateral renal agenesis is a characteristic feature in more than 50% of patients as the seminal vesicles and ureteral buds originate from the mesonephric (Wolffian) duct. For management, the transrectal ultrasound provides good visualization of the seminal vesicles and the rest of the pelvic structures providing a good guidance for aspiration of the cysts. Case presentation We present a case of a seminal vesicle fluid-filled tubular lesion. The patient first complained of vague abdominal pain with lower abdominal fullness. He was clinically evaluated, and radiological evaluation was performed using different modalities, and finally, the patient took his decision to live with it without any intervention at present. Conclusions The combination of seminal vesicle cysts and ipsilateral renal agenesis, is a rare urological anomaly with an insult during the 1st trimester is to be considered as the first suspicion. Usual manifestations are caused by the seminal vesicle cysts that cause mass effect and irritation to the surroundings in the form of urinary bladder irritation and in sometimes obstruction as well as pain/discomfort in the perineum and scrotum. Epididymitis is frequently occurring as a complication. Treatment mainly consists of removing the seminal vesicle cyst/tubular lesion.