Zinner’s syndrome: report of two cases and review of the literature

Abstract

BackgroundCongenital malformations of the seminal vesicle are uncommon, and most of them are cystic malformations. If an insult occurs between the 4th and the 13 h gestational week, the embryogenesis of the kidney, ureter, seminal vesicle, and vas deferens could be altered. Cysts of the seminal vesicle may appear with a mass effect, dysuria, epididymitis, or obstruction of the gastrointestinal and genitourinary tracts. Approximately two thirds of them are associated with ipsilateral renal agenesis, because both the ureteral buds and seminal vesicles originate from the mesonephric (Wolffian) duct. They were first described by Zinner in 1914, and 200 cases of seminal vesicle cysts associated with ipsilateral renal agenesis have been reported in the literature. Most patients with this anomaly are asymptomatic until the third or fourth decade of life. Some cases have nonspecific symptoms such as prostatism, urinary urgency, dysuria, painful ejaculation, and perineal discomfort. Transrectal ultrasonography provides good visualization of the pelvic structures and allows guidance for aspiration of the cysts.Case presentationWe present two cases of seminal vesicle cyst. The first patient had dysuria, increased frequency of urination, and haematuria. He was operated and benefited from a removal of the cyst with right ureterectomy and left ureteral reimplantation. The second patient had disorder of the digestive transit and he benefited from a laparoscopic removal of the cyst.ConclusionsSeminal vesicle cysts combined with ipsilateral renal agenesis are rare urological anomalies. Usual symptoms that are caused by the seminal vesicle cysts are bladder irritation and obstruction as well as pain in the perineum and scrotum. Epididymitis is frequently found. Treatment consists to removing the seminal vesicle cyst.

Classifying seminal vesicle cysts in the diagnosis and treatment of Zinner syndrome: A report of six cases and review of available literature

“…The larger the cyst, the earlier and obvious the symptoms present. Seminal vesicle cysts that are <5 cm stay asymptomatic and are later discovered as a palpable abdominal mass arising from the superior aspect of the prostate gland, while cysts larger than 5 cm stay symptomatic and are caused by the mass‐effect compression of the bladder or rectum (Altobelli et al, ; Aswani et al, ; Casey et al, ; Das & Amar, ; Fujita et al, ; Hihara et al, ; Hong et al, ; Kanavaki, Vidal, Merlini, & Hanquinet, ; Kenney & Leeson, ; Manousakas et al, ; McGee et al, ; Naval‐Baudin et al, ; Nistal et al, ; Ornstein & Kershaw, ; van den Ouden et al, ; Patel et al, ; Sandler et al, ; Shariat et al, ; Slaoui et al, ). Zinner syndrome can be initially determined through imaging examination after ultrasound, CT and MRI scans.…”

“…Infertility, haematuria, and haematospermia are some of the cases that may also bring a patient to medical attention. Due to its nonspecific signs and symptoms, Zinner syndrome may be missed or misdiagnosed (Campora et al, ; Fiaschetti et al, ; Kord et al, ; Slaoui et al, ). The objectives of the present study are to detail this syndrome's abnormal anatomy, define the role of noninvasive imaging in diagnosis and management, and propose a seminal vesicle cyst classification through imaging to help stratify its management.…”

Asymptomatic Zinner's Syndrome Diagnosed during the Sixth Decade of Life: Case Report and Review of the Literature

“…Kanavaki et al documented an 11-year history of this malformation from childhood to adolescence with a slow and gradual increase in size of the cyst, from 0.8 cm up to 1.9 cm [9] .…”

Zinner’s Syndrome: Case Report of a Rare Maldevelopment in the Male Genitourinary Tract

“…The clinical manifestations include voiding symptoms (dysuria, frequency, urgency), haematuria, perineal or scrotal pain, recurrent urinary tract infection, epididymitis, prostatitis, painful ejaculation, haematospermia, and infertility. Small cysts in the seminal vesicles, less than 5 cm in size, are usually asymptomatic and often detected incidentally (4,5,6,7). We report ultrasound (US) and magnetic resonance imaging (MRI) findings of this extremely rare developmental anomaly involving the mesonephric duct in a 17-year-old boy who would probably remain undiagnosed until later age.…”