Müllerian duct cyst
A Mullerian duct cyst is a cyst that arises from remnants of the Mullerian duct and is one of the midline cystic masses in the male pelvis.
Mullerian duct cysts usually occur in the 3rd and 4th decades of life (c.f. utricle cysts are most often detected in the 1st and 2nd decades).
Clinical symptoms include a pelvic mass, obstructive and irritative urinary tract symptoms, haematuria, and suprapubic or rectal pain.
Mullerian duct cysts can arise anywhere along the path of Mullerian duct regression, from scrotum to utricle (c.f. prostatic utricle cysts always arise from the level of the verumontanum and are always in the midline). They do not communicate with the urethra.
Mullerian duct cysts typically extend above the prostate gland (utricle cysts are variable in size but are usually smaller than mullenian duct cysts and usually do not extend above the prostate gland).
Mullerian duct cysts are not associated with other abnormalitis (utricle cysts are associated with a variety of genitouninany abnormalities).
- they may contain pus or haemorrhage if infected.
- they may contain cancer (i.e. endometrial carcinoma, clear cell carcinoma, or squamous cell carcinoma) with a reported prevalence as high as 3%.
- prostatic utricle cyst - can be very difficult or impossible to distinguish from a Mullerian duct cyst.
These are seen on pelvic MRI or ultrasound as midline cystic lesions in the prostate that do not communicate with the urethra.
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