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Case Reports
. 2016 May 24;11(4):313-317.
doi: 10.1016/j.radcr.2016.04.002. eCollection 2016 Dec.

Zinner syndrome-a rare developmental anomaly of the mesonephric duct diagnosed on magnetic resonance imaging

Shibani Mehra  1 , Rajeev Ranjan  1 , Umesh Chandra Garga  1
Affiliations
Case Reports

Zinner syndrome-a rare developmental anomaly of the mesonephric duct diagnosed on magnetic resonance imaging

Shibani Mehra et al. Radiol Case Rep. .

Abstract

Developmental anomalies of the urogenital tract are rare but often encountered. Zinner's syndrome is a rare congenital abnormality of mesonephric (Wolffian) duct consisting of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction due to developmental arrest in early embryogenesis affecting the caudal end of Mullerian duct and only approximately a 100 cases have been reported so far. Radiologic modalities such as intravenous pyelography, ultrasonography, vasovesiculography, contrast enhanced computed tomography, and magnetic resonance imaging are all helpful in diagnosis of this unusual entity. We present here an extremely rare developmental anomaly involving the Mullerian ducts, which would remain undiagnosed but for radiologic imaging. The patient presented with symptoms of lower urinary tract irritation.

Keywords: CT; MRI; USG; atretic ureter; ejaculatory duct; seminal vesicles.

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Figures

Fig. 1
Fig. 1
(A) Absent kidney in the right renal fossa. (B) Pelvic ultrasound shows cystic tubular structure posterior and to the right of the urinary bladder extending up to the midline. (C and D) Scrotal sonography image showing tubular dilatation in the head of epididymis with tortuous tubular nonvascular structures seen in the right spermatic cord.
Fig. 2
Fig. 2
(A) Contrast enhanced computed tomography (CECT) pelvis: axial image showing lobulated large well-marginated nonenhancing mass in the periprostatic region between the bladder and rectum. The mass is indenting the posterolateral bladder wall and extends across the midline to the left. (B) CECT pelvis-delayed images: the pelvic mass shows no contrast enhancement or excretion. (C, D) Axial CECT images: a tubular structure seen slightly to the right of the false pelvis, adjacent to the right external iliac and internal iliac arteries, ending abruptly at the level of the common iliac arteries where it appears round and cystic.
Fig. 3
Fig. 3
(A) Axial T2W MR image. Multiple cystic hyperintense structures lying close together, in the region of the right seminal vesicle, indenting the right lateral bladder wall and the bladder base, extending inferiorly into the spermatic cord. (B) Pelvic MR T2 axial image: similar cystic tubular dilated structures visible in the left seminal vesicle. MR, magnetic resonance.
Fig. 4
Fig. 4
(A, B) T2W MR: a tortuous tubular structure seen posterolaterally in the pelvis adjacent to the internal iliac vessels, on the right side in this axial T2 MR image. The structure assumes a round shape at a slightly superior level. (C) Sagittal T2W MR: image shows the tubular cystic structure extending upward from the false pelvis to the level of aortic bifurcation where it is seen to end abruptly anterior to the vessels. MR, magnetic resonance.
Fig. 5
Fig. 5
Axial computed tomography: image shows single left kidney with absent right kidney.
See this image and copyright information in PMC

References

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