Citation, DOI, disclosures and article data
Citation:
Ibrahim D, Saber M, Knipe H, et al. Zinner syndrome. Reference article, Radiopaedia.org (Accessed on 24 Apr 2024) https://doi.org/10.53347/rID-30469
Zinner syndrome is a triad of mesonephric (Wolffian) duct anomalies comprising unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction 1.
The condition is rare, with ~200 reported cases (c. 2009) 9.
Patients are typically diagnosed during the 3rd or 4th decade of life and often present with perineal pain, recurrent prostatitis, hematospermia, painful ejaculation, and infertility 1.
There is an association between congenital malformations of the seminal vesicle and the ipsilateral upper urinary tract because both the ureteral buds and the seminal vesicles originate from the mesonephric (Wolffian) duct 2,3.
Maldevelopment of the distal part of the mesonephric duct results in atresia of the ejaculatory duct (leading to obstruction and dilatation of the seminal vesicle), while an abnormality in the ureteral bud leads to renal agenesis/dysplasia 1.
Irrespective of imaging modality, the key findings are 1:
Small testis and ipsilateral ureterocele have also been reported 7 .
Treatment and prognosis
In asymptomatic patients, treatment is usually conservative, however, symptomatic patients are often treated surgically 5.
History and etymology
Zinner syndrome was first described by A Zinner in 1914 8.
Seminal vesicle cysts should be differentiated from other cysts such as 4:
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1. Ghonge N, Aggarwal B, Sahu A. Zinner Syndrome: A Unique Triad of Mesonephric Duct Abnormalities as an Unusual Cause of Urinary Symptoms in Late Adolescence. Indian J Urol. 2010;26(3):444-7. doi:10.4103/0970-1591.70592 - Pubmed
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2. Livingston L & Larsen C. Seminal Vesicle Cyst with Ipsilateral Renal Agenesis. AJR Am J Roentgenol. 2000;175(1):177-80. doi:10.2214/ajr.175.1.1750177 - Pubmed
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3. Denes F, Montellato N, Lopes R, Barbosa Filho C, Cabral A. Seminal Vesicle Cyst and Ipsilateral Renal Agenesis. Urology. 1986;28(4):313-5. doi:10.1016/0090-4295(86)90014-2 - Pubmed
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4. Kuo J, Foster C, Shelton D. Zinner's Syndrome. World J Nucl Med. 2011;10(1):20-2. doi:10.4103/1450-1147.82115 - Pubmed
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5. Seo I, Kim H, Rim J. Congenital Seminal Vesicle Cyst Associated with Ipsilateral Renal Agenesis. Yonsei Med J. 2009;50(4):560-3. doi:10.3349/ymj.2009.50.4.560 - Pubmed
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6. Naval-Baudin P, Carreño García E, Sanchez Marquez A, Valcárcel José J, Romero N. Multicystic Seminal Vesicle with Ipsilateral Renal Agenesis: Two Cases of Zinner Syndrome. Scand J Urol. 2017;51(1):81-4. doi:10.1080/21681805.2016.1257650 - Pubmed
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7. Tan Z, Li B, Zhang L et al. Classifying Seminal Vesicle Cysts in the Diagnosis and Treatment of Zinner Syndrome: A Report of Six Cases and Review of Available Literature. Andrologia. 2020;52(1):e13397. doi:10.1111/and.13397 - Pubmed
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8. Zinner A. Ein fall von intravesikaler samenblasenzyste. Weien Med Wschr. 1914;64:604–610.
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9. Pereira B, Sousa L, Azinhais P et al. Zinner's Syndrome: An Up-To-Date Review of the Literature Based on a Clinical Case. Andrologia. 2009;41(5):322-30. doi:10.1111/j.1439-0272.2009.00939.x - Pubmed
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