A unique radiological pentad of mesonephric duct abnormalities in a young man presenting with testicular swelling

Casey, Rowan G.; Stunell, Helen; Buckley, Orla; Flynn, Richard; Torreggiani, W C

doi:10.1259/bjr/31182823

Cited by 23 publications

(18 citation statements)

References 10 publications

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“…According to the postulations of Tanagho (1976) and Schulman (1978), this failure interferes with the ureteric bud pivotal role in the differentiation of the metanephric blastema and ipsilateral renal agenesis will occur (Van den Ouden et al, 1998;Manousakas et al, 2002) as well as atresia of the ejaculatory duct. This causes insufficient drainage and subsequent distension of the seminal vesicle thus originating a cystic structure (Casey et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…The seminal vesicle cyst related symptoms coincide with the beginning of sexual active life when the cyst enlarges sufficiently to produce symptoms (Casey et al, 2008). So, they occur mainly in the second and third decade of life (Heaney et al, 1987;Livingstone & Larsen, 2000) (83% of cases were found between 11 and 40 years of age) -mean age at presentation was 30.2 (Van den Ouden et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Zinner’s syndrome: an up-to-date review of the literature based on a clinical case

Pereira¹,

Sousa²,

Azinhais³

et al. 2009

Andrologia

132

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The authors made an up-to-date review of the literature concerning the management of Zinner's syndrome and evaluated a young patient with Zinner's syndrome who had presented with urinary and ejaculatory complaints. Physical examination and transrectal ultra-sonography showed a 7.0 cm right seminal vesicle cyst. Magnetic resonance imaging (MRI) confirmed the diagnosis of Zinner's syndrome. Oligoasthenoteratozoospermia was present at the two seminal analyses. Symptomatic improvement was achieved with conservative measures. Actually, the patient is still on a follow-up programme. The diagnosis is usually established at the age of increased sexual activity. Patients may be asymptomatic or present pain, irritative urinary or ejaculatory symptoms and infertility. MRI has proved to be the best imaging examination. Treatment should be adapted to symptoms, surveillance being the best option in the absence of clinical manifestations. Surgical approach may be adequate when conservative measures prove ineffective. Zinner's syndrome should be suspected if a male young patient presents with unilateral renal agenesis and pelvic complaints and has a supraprostatic mass on digital rectal examination. The initial approach should be medical, but invasive procedures may be the only way to solve the patient's complaints. Nowadays, laparoscopic and robotic techniques must replace the open surgical approach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Zinner’s syndrome: an up-to-date review of the literature based on a clinical case

Pereira¹,

Sousa²,

Azinhais³

et al. 2009

Andrologia

132

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show abstract

“…Epididymal cysts have been reported in association with seminal vesicle cysts in adult patients with autosomal dominant polycystic kidney disease [23][24][25][26] and also in patients with seminal vesicle cysts and ipsilateral renal agenesis [16,27]. In most cases, these cysts were diagnosed radiologically with no pathological documentation and are likely to be secondary to distal obstruction of the excretory duct.…”

Section: Discussionmentioning

confidence: 99%

Cystic dysplasia of the epididymis: a disorder of mesonephric differentiation associated with renal maldevelopment

et al. 2010

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The occurrence of congenital epididymal malformations with a cystic component has not been fully characterized. Most epididymal cysts occur later in life and are likely acquired. In addition, congenital malformations of the male excretory system are extremely uncommon in fetuses and neonates, and epididymal dysplastic changes have not been reported in these cases. In this study, we report 20 cases (including 19 fetal/neonatal autopsies and one surgical specimen from an older child) showing the same spectrum of histological findings in the epididymis, characterized by cystic ductal dilation with dysplastic ducts of variable diameters and irregular shapes, with ill-defined walls. Efferent ductules also showed dysplastic features. In addition, 18 cases had either renal and/or urinary tract anomalies, including renal dysplasia (eight), pelvicaliceal dilation (eight), renal agenesis (four) and hypoplasia (one), ureteral agenesis (two) and hypoplasia (one), urethra and bladder agenesis (two), prostate agenesis (two), and autosomal recessive polycystic renal disease (two). Our observations led to the recognition of a peculiar, not previously described congenital lesion of the epididymis, and we propose the term cystic dysplasia of the epididymis for this anomaly. Similar to what is observed in other male genital system anomalies (including malformations of the rete testis, vas deferens, and seminal vesicles), most lesions occurred in association with renal and/or urinary tract malformations, suggesting a spectrum of congenital malformations. The shared embryological origin of these structures may explain their simultaneous occurrence, possibly related to disrupted mesonephric duct development.

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“…A unique pentad of mesonephric duct abnormalities on imaging, including cystic dysplasia of rete testis, seminal vesicle cyst, ipsilateral renal agenesis, partial hemitrigonal development, and epididymal dilatation were described by the Casey et al (12). This pentadology includes an extension into the testicular and epididymal structures.…”

Section: Discussionmentioning

confidence: 97%

Congenital seminal vesicle cyst accompanying with ipsilateral renal agenesis in an adolescent patient: A pediatric radiologist approach to Zinner’s syndrome

Özkan

Bilgici

Sahin

et al. 2015

The Egyptian Journal of Radiology and Nuclear Medicine

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A fifteen-year-old boy who had complaints of left sided pelvic pain with known ipsilateral left renal agenesia was referred to pediatric radiology department. Incidentally, his sonography examination revealed a dilated tubular structure located in the retro-vesicular region from cephalic to prostate. Contrast enhanced pelvic MRI showed a huge seminal vesicle cyst which is over 6 cm without a mass effect near the aspect border of the prostate and bladder. The patient was diagnosed with Zinner syndrome. The patient doesn't have new complaint with no definite increase in the diameter of the cyst. In this case presentation we are discussing the Zinner syndrome's imaging findings from a pediatric radiologist approach with a brief review of the literature.

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A unique radiological pentad of mesonephric duct abnormalities in a young man presenting with testicular swelling

Cited by 23 publications

References 10 publications

Zinner’s syndrome: an up-to-date review of the literature based on a clinical case

Zinner’s syndrome: an up-to-date review of the literature based on a clinical case

Cystic dysplasia of the epididymis: a disorder of mesonephric differentiation associated with renal maldevelopment

Congenital seminal vesicle cyst accompanying with ipsilateral renal agenesis in an adolescent patient: A pediatric radiologist approach to Zinner’s syndrome

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