A Müllerian duct cyst is a cyst that arises from remnants of the Müllerian duct and is one of the midline cystic masses in the male pelvis.
Müllerian duct cysts usually occur in the 3rd and 4th decades of life (whereas 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.
Müllerian duct cysts can arise anywhere along the path of Müllerian duct regression, from scrotum to prostatic utricle (whereas prostatic utricle cysts always arise from the level of the verumontanum and are always in the midline). They do not communicate with the urethra.
Müllerian duct cysts typically extend above the prostate gland (utricle cysts are variable in size but are usually smaller than Müllerian duct cysts and usually do not extend above the prostate gland).
Müllerian duct cysts are not associated with other abnormalities (utricle cysts are associated with a variety of genitourinary abnormalities).
- may contain pus or haemorrhage if infected
- may contain cancer (i.e. endometrial carcinoma, clear cell carcinoma, or squamous cell carcinoma) with a reported prevalence as high as 3%
These are seen on pelvic MRI or ultrasound as midline cystic lesions in the prostate that do not communicate with the urethra.
- prostatic utricle cyst - can be very difficult or impossible to distinguish from a Müllerian duct cyst
- 1. Nghiem HT, Kellman GM, Sandberg SA et-al. Cystic lesions of the prostate. Radiographics. 1990;10 (4): 635-50. Radiographics (abstract) - Pubmed citation
- 2. Curran S, Akin O, Agildere AM et-al. Endorectal MRI of prostatic and periprostatic cystic lesions and their mimics. AJR Am J Roentgenol. 2007;188 (5): 1373-9. doi:10.2214/AJR.06.0759 - Pubmed citation
- 3. Shebel HM, Farg HM, Kolokythas O et-al. Cysts of the lower male genitourinary tract: embryologic and anatomic considerations and differential diagnosis. Radiographics. 2013;33 (4): 1125-43. doi:10.1148/rg.334125129 - Pubmed citation
- 4. Shabsigh R, Lerner S, Fishman IJ et-al. The role of transrectal ultrasonography in the diagnosis and management of prostatic and seminal vesicle cysts. J. Urol. 1989;141 (5): 1206-9. Pubmed citation