Zinner's syndrome: A rare diagnosis of congenital seminal vesicle cyst and renal agenesis on basis of radiological imaging and its management

Zinner Syndrome in a Young Male: A Case Report and Review of the Literature

Zinner syndrome is an extremely uncommon congenital anomaly of the male urogenital tract. It is attributed to an embryological anomaly that arises in the distal segment of the mesonephric or Wolffian duct. It is the inadequate migration of the ureteric bud that contributes to the failure of differentiation of the metanephric blastema, which ultimately results in ipsilateral renal agenesis and atresia of the ejaculatory duct. This condition is characterized by a triad of unilateral renal agenesis, ipsilateral seminal vesicle cysts, and ipsilateral obstruction of the ejaculatory duct. In this case report, we describe a 19-year-old male patient who arrived at the general medicine outpatient department with a dull, aching pain in his abdomen and pelvis, accompanied by a feeling of fullness in his pelvis. He had no history of dysuria, hematuria, or ejaculatory pain. The ultrasound scan, computed tomography, and magnetic resonance imaging of the abdomen and pelvis revealed the absence of the right kidney and compensatory hypertrophy of the left kidney. Another well-defined oblong cystic lesion was seen involving the right seminal vesicle without any enhancement in the post-contrast study. Following a discussion regarding the condition of the patient and radiological findings with the urology team, a diagnosis of Zinner syndrome was established. This was subsequently communicated to the patient, who was presented with various treatment options. He expressed a preference to manage his present relatively mild symptoms and opted for follow-up evaluations. The current case report is intended to highlight a very rare case of Zinner syndrome. In addition, a short overview of the scientific literature was taken into consideration with regard to the specifics of the developmental defect, the primary symptoms, the imaging features, and the potential treatment options.

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.

The role of radiology in diagnosis of Zinner syndrome in a young man with scrotal pain

Zinner Syndrome is a rare congenital anomaly. It is considered a rare cause of male infertility and can cause a range of clinical manifestations that may lead to significant morbidity. The diagnosis of Zinner Syndrome requires a high index of suspicion, combined with a detailed clinical evaluation and imaging studies. Ultrasonography, computed tomography, and MRI are the imaging modalities of choice for the diagnosis of this condition. Radiological evaluation also plays a crucial role in the management of Zinner Syndrome. In symptomatic cases, surgical intervention may be necessary, and radiology is essential for surgical planning and postoperative monitoring. In this case report, we describe an uncommon case of a 35-year-old patient with vague scrotal pain and discuss the clinical presentation, diagnosis, and management of this rare condition. Prompt and accurate diagnosis is important to prevent the potential morbidity associated with this condition, such as recurrent epididymitis, urinary tract infections, and infertility.

Zinner syndrome: A first case report from Ethiopia

A triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and ipsilateral ejaculatory duct obstruction has been called Zinner syndrome since its first description in 1914 by Zinner. It is a very rare congenital abnormality of the male genitourinary tract due to abnormal embryologic development of the Wolffian ducts. There have been several case reports from different parts of the world about the clinical and imaging findings of these anomaly. In this case report, we present the first case report of Zinner syndrome in a 28-year-old male Ethiopian patient.