Zinner Syndrome Unmasked by Workup for Renal Colic and Uncontrolled Hypertension

Abstract

Zinner syndrome is a rare hereditary disorder of the mesonephric duct. The triad of the absence of one kidney, ipsilateral cystic dilatation of the seminal vesicle, and ejaculatory duct obstruction makes the diagnosis. Mostly, it is asymptomatic. However, genitourinary manifestations and workup for the incidental absence of one kidney often uncover the disease. Ultrasound and CT scan can identify the absence of a kidney and seminal vesicle cyst, while MRI is the gold standard for diagnostic elaboration of the pelvic anatomy. In this article, we have presented a 51-year-old male patient who presented with renal colic and hypertension. Radiological investigations for the renal colic uncovered the diagnosis of Zinner syndrome incidentally. This case highlights the incidental nature, variability in the clinical presentation, and the diagnostic challenges of this rare disorder. It also emphasizes on the radiologist for a careful evaluation of the pelvic images in patients with unilateral absence of a kidney.

A Rare Disease Leading to Hypertension

“…6 After the stone was removed, his blood pressure returned to the original level. 6 Diagnosis of the syndrome is based principally on imaging modalities, including magnetic resonance imaging, computed tomography, and ultrasonography, which reveal the characteristic cystic dilatations of the seminal vesicle and ipsilateral renal agenesis. 7 Seminal vesicle cyst associated with contralateral renal agenesis is an extremely rare condition.…”

“…One exception was a case with an obstructing ureteral stone causing upstream hydroureteronephrosis and uncontrolled high blood pressure. 6 After the stone was removed, his blood pressure returned to the original level. 6 Diagnosis of the syndrome is based principally on imaging modalities, including magnetic resonance imaging, computed tomography, and ultrasonography, which reveal the characteristic cystic dilatations of the seminal vesicle and ipsilateral renal agenesis.…”

The role of radiology in diagnosis of Zinner syndrome in a young man with scrotal pain

“…This noninvasive technique can detect seminal vesicle cysts and the absence of the ipsilateral kidney, additionally there may be internal echoes in a cyst as a result of infection or hemorrhage. Ultrasonography can also be used to monitor the progression of the cystic lesions and the response to treatment [ 5 , 7 ]. CT scan is another reliable diagnostic option.…”

A Rare Cause of Acute Urinary Retention in a Young Man: Zinner Syndrome

“…Zinner syndrome is diagnosed radiologically using various imaging methods. The gold standard diagnostic imaging techniques include US or CT in the first stage and MRI imaging as a further examination [8]. Ureteral anomalies may present in different forms in Zinner syndrome.…”