Presentation
Work up for male infertility.
Patient Data
right-sided renal agenesis
cystic dilatation of the seminal vesicle on the right side
dilatation of the right-sided vas deferens from the posterior aspect of the prostate extending into the right inguinal canal;
dilated duct is seen to indent the posterior wall of the urinary bladder
right-sided ectopic ureter opening into the right vas deferens inferiorly; superiorly it has a blind end
left kidney is normal
point to note is the high signal intensity within the dilated ducts on T1W images probably due to high proteinaceous content as a result of stasis
Curved MPR reveals a right-sided ectopic ureter inserted into the dilated vas deferens on the right side
Case Discussion
A case of Zinner syndrome with an ectopic insertion of the right ureter into the dilated vas deferens.
Key points of this syndrome:
is a triad of Mullerian duct anomalies comprising unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction
typically diagnosed at 3rd or 4th decade of life
occurs due to maldevelopment of the distal part of the mesonephric duct which results in atresia of the ejaculatory duct (leading to obstruction and dilatation of the seminal vesicle) and abnormal ureteral budding (leads to renal agenesis/dysplasia)
An additional finding in this case:
high T1W signal intensity within the dilated ducts is probably due to high proteinaceous content as a result of stasis
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