Presentation
Chronic pelvic pain and an episode of urine retention.
Patient Data
A well-defined pear-shaped cyst measuring 7 x 9 x 11 mm, low signal on T1 and high signal on T2 weighted imaging is seen in the midline posterior mid prostate gland between the openings of two ejaculatory ducts. It has no extension beyond the superior margins of the prostate gland and is likely a prostatic utricle cyst although no definite communication is visualized with the prostatic urethra.
Mild diffuse low signal intensity on T2 weighted images with mild diffusion restriction in both peripheral zones, particularly more extensive on the left side, likely representing prostatitis.
Minimal bilateral hydroceles.
Case Discussion
Prostatic utricle cysts are midline intraprostatic cysts between the two openings of the ejaculatory ducts, often less than 10 mm in diameter, classically described as pear-shaped, and rarely extend beyond the upper border of the prostate. By definition, utricle cysts communicate with the urethra; however, this communication is not always visible on imaging. MRIs are hyperintense on T2 and hypointense on T1 weighted imaging. Heterogenous T1 hyperintensity can be seen in cases of intracystic hemorrhage or infection 1.
Mullerian duct cysts are also midline prostatic cysts and in contrast to the utricle cysts, Mullerian duct cysts are typically larger, oval or tear drop in shape, extend beyond the superior border of the prostate and rarely communicate with the urethra. The MRI signals are similar to the simple utricle cysts, appearing homogenously hyperintense on T2 weighted imaging 1.
Unable to process the form. Check for errors and try again.