Zinner's syndrome in two young middle-aged men: a case report and review of the literature

Abstract

Zinner syndrome (ZS) is a relatively uncommon congenital genitourinary malformation, characterised by a triad of conditions: unilateral renal hypoplasia or dysplasia, ipsilateral ejaculatory duct obstruction and seminal vesicle cysts. This association is caused by the hypoplasia of the distal portion of the Wolffian duct between the 4th and 13th week of gestational age. To date, approximately 221 cases have been documented, the majority of which are case reports, with only a few being retrospective studies. However, the number of cases remains relatively limited. The lack of a clear and consistent set of symptoms can result in misdiagnosis. This paper presents two patients with two different presentations of Zinner syndrome. Clinical trial number: Not applicable.

Keywords: Genitourinary anomalies; Infertility; Robotic surgery; Zinner syndrome.

Fig. 1

Enhanced CT. Coronal CT (A) shows left renal hypoplasia, right renal hypertrophy and a left anomalous ureter. Axial (B) and sagittal (C) views demonstrate cyst protrusion into the bladder. MRI: Coronal (D) and sagittal (F) MRI reveal a left seminal vesicle cyst. This dilated cystic structure extends into the bladder (D, E, F)

Fig. 2

Enhanced CT. Coronal images (A) demonstrated left renal hypoplasia and right renal hypertrophy. Axial images (B) revealed a mass-like hyperdense shadow on the left side of the pelvis. Sagittal images (C-D) shows the large shadow poorly demarcated from the left seminal vesicle glands. Magnetic resonance imaging (MRI): The coronal (E) and sagittal (F) images demonstrated the presence of bilateral seminal vesicle glands with full morphology. The images revealed a thickened and tortuous left seminal vas deferens and uneven signals in the right epididymis(G-H)