Seminal Vesicle Cyst Research Articles

CT and MRI radiographic characteristics of seminal vesicle cysts

PurposeSeminal vesicle cysts are relatively uncommon benign lesions. Early and accurate diagnosis is crucial for guiding appropriate management strategies. The purpose of this study was to investigate the radiographic characteristics of seminal vesicle cysts in order to enhance the diagnostic proficiency of radiologists. MethodsWe conduct a comprehensive descriptive analysis of the CT and MRI findings pertaining to 15 patients with seminal vesicle cyst, complemented by a brief literature review. ResultThe mean age of 15 patients with seminal vesicle cyst was 57.53 ± 17.0 years. Among these patients, 53.33% (8/15) were incidentally detected, while 40% (6/15) presented with symptoms of abdominal or pelvic pain. One patient exhibited hematospermia. In 86.67% (13/15) of cases, the cysts were unilateral, while the remaining 13.33% (2/15) were bilateral. Radiological assessment comprised CT scans for 7 patients, MRI scans for 12 patients, and a combination of both modalities for 4 patients. Imaging characteristics revealed 11 cases of unilocular cysts and 4 cases of multilocular cysts, with the largest measuring approximately 16.0 × 9.8 cm. CT imaging distinctly demonstrated punctate or nodular calcification along the cyst wall in 3 cases. MRI, on the other hand, facilitated the visualization of cystic contents, including mucinous protein in 9 cases and hemorrhagic components in 2 cases. ConclusionThe radiographic manifestations of seminal vesicle cysts exhibit distinct characteristics, CT and MRI imaging modalities are instrumental in facilitating their accurate diagnosis.

Robotic Excision of a Huge Seminal Vesicle Cyst, Including Intracystic Papillary Adenoma, Saving Fertility

Robotic Excision of a Huge Seminal Vesicle Cyst, Including Intracystic Papillary Adenoma, Saving Fertility

A case with an ectopic ejaculatory duct opening into the bladder trigone in Zinner syndrome, congenital unilateral renal agenesis, and an ipsilateral seminal vesicle cyst

IntroductionThis report describes a case with an ectopic ejaculatory duct opening into the bladder trigone in Zinner syndrome, congenital unilateral renal agenesis, and an ipsilateral seminal vesicle cyst.Case presentationThe patient was identified when no left kidney was detected in the fetal period. Abdominal ultrasonography and pelvic plain MRI at 6 months old revealed a 10‐mm cystic lesion on the dorsal aspect of the bladder. Cysto‐urethroscopy at 1 year old revealed a rather short posterior urethra and right and left inferior crests extending from the posterior urethra beyond the bladder neck. The ejaculatory duct opening was identified on the bladder trigone.ConclusionAnatomical abnormality of the ejaculatory duct may represent a cause of infertility and ejaculatory dysfunction in Zinner syndrome. Endoscopic evaluation should be performed for this rare anomaly, even in children.

506 Large Seminal Vesicle Cyst Displacing Bladder into Inguinal Hernia – a First of Its Kind

506 Large Seminal Vesicle Cyst Displacing Bladder into Inguinal Hernia – a First of Its Kind

Zinner syndrome: a radiological journey through a little known condition.

Zinner syndrome is a rare congenital urological entity, secondary to an alteration in embryogenesis between 4th and 13th weeks of gestation, specifically because of abnormalities in the development of the distal mesonephric duct. It is characterized by the triad of unilateral renal agenesis, cystic dilatation of the ipsilateral seminal vesicle and ipsilateral ejaculatory duct obstruction. The aim of this article is to provide the reader with all the necessary information to be able to suspect the presence of this syndrome, reviewing its physiopathology, clinical manifestations and the imaging techniques that enable its diagnosis, emphasizing those radiological findings by MRI that should lead us to think about it. This work is illustrated with representative radiological images of cases belonging to our institution, including patients with different variants of Zinner syndrome. We also include an overview of the embryology of the male urogenital system, to remember the role of the mesonephric duct and the ureteral bud in the formation of the different urogenital structures, as well as a differential diagnosis that allows us to differentiate seminal vesicle cysts from other pelvic cystic lesions.

Zinner syndrome in pediatric age group: An underdiagnosed entity

Zinner Syndrome (ZS), a rare congenital malformation of the mesonephric duct, combines seminal vesicle cyst (SVC) with ipsilateral upper urinary tract abnormalities. Typically asymptomatic in childhood, ZS manifests between 2nd to 4th decades with bladder symptoms, perineal pain and infertility. Diagnostic confirmation with additional imaging is needed when either renal or seminal abnormalities are identified. A retrospective study spanning 22 years identified 20 pediatric ZS cases through clinical analytics. Demographic, clinical, and radiological data were analyzed, including presenting complaints, imaging modalities (ultrasound, CT, MRI), and surgical findings. The study was HIPAA-compliant and IRB-approved. Among 20 cases (mean age: 7.3 years), clinical presentations included asymptomatic cases, urinary symptoms, and abdominal pain. Imaging revealed renal anomalies (agenesis, multicystic dysplastic kidney) and seminal vesicle abnormalities. Surgical interventions (n=12) addressed symptomatic cases, often involving robotic or laparoscopic procedures. ZS, though rare, presents with varied clinical features, necessitating a multidisciplinary approach. Early diagnosis is facilitated by prenatal identification of renal abnormalities. Surgical intervention is reserved for symptomatic cases, with techniques such as vesiculectomy and resection of remnant structures employed. This study highlights ZS's diverse clinical and radiological spectrum, emphasizing the need for vigilance in detecting overlapping entities. Timely identification, utilizing advanced imaging techniques, is crucial for accurate diagnosis and appropriate management of Zinner Syndrome in the pediatric population.

Robotic excision of a giant seminal vesicle cyst

Abstract Zinner syndrome is a rare congenital condition characterized by unilateral renal agenesis, ejaculatory duct obstruction, and seminal vesicle cyst. This syndrome is caused by an embryonic malformation of the mesonephric or Wolffian duct. Seminal vesicle cysts are commonly reported, and men with these cysts often present with infertility. This report presents a case of a giant seminal vesicle cyst that was incidentally found while evaluating for bowel symptoms. The seminal vesicle cyst was successfully managed by robot-assisted excision.

Incidental Zinner Syndrome in Nigeria: A Case Report

Zinner syndrome (ZS) is a rare urogenital condition characterised by the triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction, resulting from malformation during early embryogenesis of the mesonephric (Wolffian) duct. The authors present a 35-year-old male who was being evaluated for chronic hepatitis B virus infection. He was referred to the urology outpatient clinic on account of incidental ultrasound finding of solitary right kidney. General physical examination revealed a healthy-looking young male with a flat abdomen and no palpable enlarged organs. Digital rectal examination revealed normal sized prostate with no palpable pararectal masses. MRI of the pelvis revealed a triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction. The clinical diagnosis was asymptomatic ZS. He is on yearly follow-up at the urology outpatient clinic for lower urinary tract symptoms, pelvic pain, painful ejaculation, features of infertility, and pelvic ultrasound. If any of these symptoms occur, he will be treated with an α-adrenergic receptor blocker, drainage of the seminal vesicle cyst, and appropriate treatment for infertility. He is also on active surveillance for viral hepatitis by the gastroenterology team. In conclusion, prompt referral and comprehensive radiological imaging investigations of patients with unilateral agenesis of the kidney will lead to increased identification and report of patients with ZS. There is paucity of literature reports on ZS in the authors’ environment, and this case report, to the best of the authors’ knowledge, is the first from Nigeria.

Zinner syndrome in pediatric age: Clinical image

Zinner Syndrome (ZS) is a rare genitourinary malformation characterized by the triad of unilateral seminal vesicle cyst (QVS), ipsilateral Multicystic Displastic Kidney (MCDK), and obstruction of the ejaculatory duct. This condition is rare in pediatric age and both diagnosis and treatment are challenging.

Zinner syndrome in pediatric patients: rare disease leading to challenging management.

Zinner syndrome (ZS) is the association of seminal vesicle cysts, ipsilateral ejaculatory duct obstruction, and ipsilateral renal agenesis. This condition is very rare in children and both diagnosis and treatment may be challenging. We reviewed the clinical presentation and treatment describing our experience with a series of three patients. From January 2016 to January 2021, three patients (patients 1, 2, and 3) with symptomatic ZS, aged 2, 15, and 17 years, respectively, were diagnosed and treated. All three patients were symptomatic, manifesting pelvic pain and dysuria. The diagnosis was made by physical examination, ultrasonography, and abdominopelvic MRI. Patient 1 underwent open surgery, while for patients 2 and 3, laparoscopic excision was performed. The renal agenesis regarded the left side in patients 1 and 3, and the right side in patient 2. In all cases, the cystic complex was excised. The mean operating time was 4 h and the mean hospitalization time was 5 days (range 4-6 days). The mean follow-up period was 5 years (range 2-5 years). Patients 1 and 3 showed a complete resolution of the symptoms during postoperative follow-up. In patient 2, clinical symptoms relapsed because of the persistence of a 9 mm cyst requiring a redo laparoscopic excision. Seminal vesicle cyst with ipsilateral renal agenesis, even if rare in pediatric age, should be suspected in young male patients presenting with pelvic cystic masses, pelvic pain, dysuria, and ipsilateral renal absence. Conservative management should be reversed to asymptomatic patients. Surgical treatment is mandatory in symptomatic cases and the preferred approach is minimally invasive surgery to magnify the operating field to spare anatomical structures, primarily the contralateral vas deferens. Radicality is crucial to avoid the persistence of symptoms and the need for reintervention.

Durable response to docetaxel in a case of primary seminal vesicle adenocarcinoma with zinner syndrome.

Primary adenocarcinoma of the seminal vesicles is a rare tumor. Congenital seminal vesicle cysts are often associated with unilateral renal dysgenesis or agenesis (Zinner syndrome). Zinner syndrome is a rare congenital malformation represented by a group of characteristics: ipsilateral renal agenesis, ejaculatory duct obstruction, and seminal vesicle cyst. There have been 214 cases in the literature with abdominal pain and lower urinary tract symptoms as the most common presentation. Most cases are diagnosed incidentally. We report a case of a 39-year-old male presenting with recurrent hematuria for 12 years, diagnosed as metastatic primary clear cell adenocarcinoma of seminal vesicle with Zinner syndrome. He was managed symptomatically with radiation therapy, hormonal therapy, and palliative chemotherapy. He is living with a well-controlled disease at present.

UNILATERAL EJACULATORY DUCT OBSTRUCTION: A CASE STUDY OF ZINNER'S SYNDROME

Zinner’s syndrome is a rare congenital mesonephric (Wolffian) duct anomaly due to developmental arrest in early embryogenesis, comprising unilateral ejaculatory duct obstruction or agenesis, ipsilateral seminal vesicle cysts, and ipsilateral renal agenesis. Here, we present a case of a healthy 17-year-old male in Pakistan presenting with complaints of mild, dull pain in the left lower abdomen. He had no history of lower urinary tract symptoms and regular bowel habits. Imaging revealed non-visualization of the left kidney with multi-cystic pelvic mass related to the left seminal vesicle in keeping with the diagnosis of Zinner’s syndrome.

Zinner Syndrome: Left Unilateral Renal Dysgenesis with Seminal Vesicle Cyst and Ipsilateral Testicular Atrophy Associated with Azoospermia - Case Report

Seminal vesicular cysts associated with ipsilateral renal agenesis or hypoplasia are a rare urological abnormality. This combination of urinary and genital abnormalities occurs due to the closely related embryological origin of these structures from the distal mesonephric duct [Wolff]. This case illustrates the discovery of this malformation in adulthood following chronic pelvic pain associated with infertility. The diagnostic approach consisted of a clinical examination with the performance of a set of imaging examinations including a suprapubic ultrasound, a scanner and an MRI. While the therapeutic management was limited to an ultrasound-guided evacuating puncture of the cyst of the seminal vesicle with a bacteriological and histological analysis of the puncture liquid. Given the complexity of the case, our surgical treatment is mainly aimed at relieving pain by evacuating puncture and offering medically assisted procreation for her infertility. We report the case of a young patient with Zinner's syndrome associated with infertility.

Zinner Syndrome: Case Series and Literature Review

Zinner syndrome is a rare congenital anomaly of the mesonephric duct, characterized by a triad of symptoms: seminal vesicle cysts, ipsilateral renal agenesis and ejaculatory duct obstruction. This leads to a severe complication — oligozoospermia/azospermia, which can subsequently cause infertility. The widespread use of medical imaging increases the probability of incidental detection. Namely, magnetic resonance imaging (MRI) is the imaging modality of choice for making a diagnosis. Study purpose: to optimize patient routing in Zinner syndrome, as well as to minimize the risk of misdiagnosis or missed pathology, by providing strong and weak points for each modality. Materials and methods: we present two clinical cases of Zinner syndrome. The first one is a complicated course in a 25-year-old patient, and the second one is accidentally discovered in a 27-year-old patient. The patients underwent a comprehensive diagnostic panel, including: ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI). The results obtained were analyzed in the light of available literature data. Results: in most cases, Zinner syndrome is an incidental finding during. The diagnosis based on these imaging methods and the correct patient routing allowed us to make a timely and correct diagnosis, followed by decisions on further treatment tactics. Conclusion: Zinner syndrome is a rare disease and is often diagnosed based on imaging findings only. A radiologist and clinician need to know about the diagnostic criteria for this syndrome in order to successfully diagnose and determine the optimal treatment tactics.

Clinicopathological and genetic features of Zinner’s syndrome: two case reports and review of the literature

Zinner’s syndrome (ZS) is a rare congenital malformation due to abnormal development of the urogenital tract. It is characterized by the triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and ipsilateral ejaculatory duct obstruction. Cases are rarely reported in China since the incidence of the disease is low. Symptoms also vary widely among patients and its etiology is unclear. In this article, we described two patients with totally different cinicopathological and genetic features based on exon sequencing.

Zinner’s Syndrome: Case report of a Developmental Anomaly of the Mesonephric Duct

Zinner’s syndrome is a rare congenital malformation characterized by the association of unilateral renal agenesis with ipsilateral seminal vesicle cyst and ejaculatory duct obstruction. Most patients are asymptomatic until the third or fourth decade of life when the syndrome is associated with dysuria, perineal pain, infertility, and painful ejaculation. In this report, we present the common imaging findings of this rare developmental anomaly involving the mesonephric duct in a 48-year-old male patient experiencing pelvic pain, recurrent dysuria, and pollakiuria.

Zinner's syndrome: clinical case of a rare pathology

Zinner’s syndrome is a rare congenital urogenital anomaly characterised by the triad of seminal vesicle cyst, ipsilateral renal aplasia, and seminal duct obstruction. According to the published data, the incidence of seminal vesicle cysts with ipsilateral renal agenesis is 0.0046%, but the true incidence appears to be higher. The article presents a rare clinical case of patient K, 17 years old, followed since birth with a solitary right kidney. The patient was repeatedly examined (ultrasound, cystography, urography, abdominal MRI, pelvic CT). The boy was admitted to our clinic with the diagnosis of "Solitary right kidney" and pelvic cystic formation detected according to the last CT scan. MRI examination of the small pelvis, cystoscopy, diagnostic laparoscopy, puncture of the cystic mass were performed. The diagnosis of "Zinner's syndrome" was made. The size of the cyst did not change during follow-up.

Screening for Zinner Syndrome in Patients With a Congenitally Solitary Kidney: Lessons Learned.

We determined if serial screening ultrasounds are beneficial in evaluating for the development of Zinner syndrome in males with a congenital solitary kidney. All patients included had their congenital solitary kidney diagnosed at <20 years of age and had to be ≥20 at their last visit. Individuals were seen annually, with pelvic ultrasounds to screen for mesonephric duct cysts obtained at birth and every year of age, divisible by 5. At a median follow-up of 38 years of age (range 20-57), 17% (20/121) developed Zinner syndrome, with 60% (12/20) developing clinical symptoms. The yield for screening ultrasound studies was significantly higher in patients ≤20 years of age at 3.5% (12/340), compared to 0.33% (1/296) in patients >20 years of age (P = .004). Serial ultrasounds reveal the onset of lower urinary tract and cyst-related pain symptoms are associated with the growth of the seminal vesicle cyst to ≥5 cm (P = .0198). Of symptomatic patients, 75% (8/12) had abnormal uroflows. Complete urodynamic studies revealed findings consistent with bladder outlet obstruction in 38% (3/8), equivocal for obstruction in 24% (2/8), and detrusor underactivity in 38% (3/8). Cyst excision effectively resolved voiding symptoms that were obstructive in etiology but failed to resolve symptoms in patients with detrusor underactivity. Serial ultrasound evaluations reveal that cyst growth to ≥5 cm in size is highly related to the onset of clinical symptoms, with the resolution of voiding symptoms by cyst excision directly associated with urodynamic findings.

VE34 - Robot-assisted excision of huge seminal vesicle cyst in patient with zinner’s syndrome

VE34 - Robot-assisted excision of huge seminal vesicle cyst in patient with zinner’s syndrome

Case Report: Incidental finding of Zinner syndrome in an asymptomatic 53-year-old Palestinian male

IntroductionZinner syndrome (ZS) is a rare condition characterized by a triad of seminal vesicle cyst (SVC), ipsilateral ejaculatory duct obstruction, and ipsilateral renal agenesis. The diagnosis is often delayed due to non-specific symptoms, such as lower urinary tract symptoms and infertility, typically appearing in the second and third decades of life.Case presentationWe present the first published case of ZS in Palestine, involving a 53-year-old male patient who sought medical attention for right-sided hernia repair. Pre-operative imaging revealed a combination of findings, including a solitary left kidney with cysts, mild hydronephrosis, an enlarged prostate, suspicious soft tissue density, and abnormal lymph nodes. The diagnosis of ZS was confirmed through an abdominal ultrasound, identifying a dilated seminal vesicle and completing the criteria of ZS.DiscussionThe typical for ZS is to present in late second decade of life with nonspecific urogenital symptoms and infertility, However, our patient’s incidental diagnosis during the preoperative evaluation of incisional hernia in a relatively old age with no previous complaints, the identification of a high aortic bifurcation at the level of the left kidney and a double Inferior Vena Cava (IVC) in this case of ZS represents novel and distinctive findings not commonly reported in previous cases.ConclusionOur patient’s presentation and findings expand our understanding of the anatomical variations associated with ZS. This case report contributes to the advancement of knowledge in the field of ZS and provides valuable insights for future clinical management and research investigations.