Zinner′s Syndrome

Abstract

A 52-year-old male was subjected to an F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) study for the evaluation of newly diagnosed non-Hodgkin's lymphoma. An incidental non-FDG avid urinary bladder mass was detected, as well as an absent kidney. Ureterocele was suspected, but subsequently a seminal vesicle cyst was confirmed on a CT urogram.

Male Genitourinary System

“…This form of cyst may be congential or acquired secondary to inflammation or obstruction (Kuo et al 2011). The congenital form is associated with ipsilateral renal agenesis in as many as 80% of cases, although this entity has been described in less than 100 case reports (Cherullo et al 2002;Kuo et al 2011). As this entity is often asymptomatic, it is thought that the increasing use of CT and MRI has also increased the detection of these cysts (Pereira et al 2009).…”

“…The associated dysplastic or absent kidney is due growth of the ureteral bud too early or too cranially so that it does not fuse with the metogephrogenic blastema, which is integral for normal renal development. Alternatively, there may be an intrinsic anomaly of the ureter that prevents it from normal interaction with the metanephrogenic blastema (Cherullo et al 2002;Kuo et al 2011). A study of infants with seminal vesicle cysts showed that these were most commonly associated with a multicystic dysplastic kidney and less commonly with a dysplastic kidney.…”

“…While most seminal vesicle cysts remain asymptomatic and are found incidentally, when they do cause symptoms, patients usually present in the third-fifth decade of life or when the patient becomes sexually active (Cherullo et al 2002;Basillote et al 2004;Kuo et al 2011). Most commonly they may cause perineal or suprapubic pain or irritative voiding symptoms such as frequency, urgency, dysuria, and hematuria.…”

“…Most commonly they may cause perineal or suprapubic pain or irritative voiding symptoms such as frequency, urgency, dysuria, and hematuria. They may also cause infertility, epididymitis, prostatitis, hematospermia, or even urinary retention (Bernstein et al 2004;Cherullo et al 2002;Basillote et al 2004;Kuo et al 2011). …”

“…Cysts have high-intensity signal on T1-weighted images (Murphy et al 2003;Pereira et al 2009). Vasovesiculography is the gold standard, but rarely used except intraoperatively due to its invasiveness (Cherullo et al 2002;Kuo et al 2011). The differential diagnosis of a seminal vesicle cyst includes enlarged prostatic utricle, Müllerian duct cyst, intraprostatic cyst, ejaculatory duct cyst, hydronephrotic pelvic kidney or ureters, bladder diverticula, or ureterocele.…”