Zinner syndrome

Case contributed by Dr Aditya Shetty

Presentation

Work up for infertility.

Patient Data

Age: 35
Gender: Male
Modality: MRI

MRI findings:

  • right sided renal agenesis
  • cystic dilatation of the seminal vesicle on the right side 
  • dilatation of the right sided vas deferens from posterior aspect of prostate extending into the right inguinal canal; 
  • dilated duct is seen to indent the posterior wall of urinary bladder
  • right sided ectopic ureter opening into the right vas deferens inferiorly; superiorly it has a blind end
  • left kidney is normal
  • point to note is the high signal intensity within the dilated ducts on T1W images probably due to high proteinaceous content as a result of stasis
Modality: CT

Curved MPR reveals a right sided ectopic ureter inserting into the dilated vas deferens on the right side

Case Discussion

Case of Zinner syndrome with ectopic insertion of right ureter into the dilated vas deferens.

Key points of this syndrome:

  • is a triad of Mullerian duct anomalies comprising of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction

  • typically diagnosed at 3rd or 4th decade of life

  • occurs due to maldevelopment of the distal part of the mesonephric duct which results in atresia of the ejaculatory duct (leading to obstruction and dilatation of the seminal vesicle) and abnormal ureteral budding (leads to renal agenesis/dysplasia)

Additional finding in this case:

  • high T1W signal intensity within the dilated ducts probably due to high proteinaceous content as a result of stasis
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Case Information

rID: 34826
Case created: 10th Mar 2015
Last edited: 1st Oct 2015
System: Urogenital
Inclusion in quiz mode: Included

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