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Zinner's syndrome: Masquerading as pyonephrotic ectopic kidney. Radiol Case Rep 2022; 18:131-134. [PMID: 36340236 PMCID: PMC9630616 DOI: 10.1016/j.radcr.2022.09.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/15/2022] [Accepted: 09/17/2022] [Indexed: 11/07/2022] Open
Abstract
Zinner's syndrome is a rare developmental anomaly of Wolffian duct, comprising a triad of seminal vesicle cyst, ipsilateral renal agenesis and ejaculatory duct obstruction, first described by Zinner in 1914. Several aberrations have been reported like renal dysplasia, ectopic ureteric orifice in one of the derivatives of Wolffian duct. Usually it presents in second to fourth decade of life with symptoms of urinary bladder irritation/obstruction, cyst distension, ejaculatory duct obstruction. The diagnosis is principally based on imaging studies, usually confirmed by MRI. Treatment is based upon the persistent symptoms or complications related to it. Excision of cyst is gold standard.
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2
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Marzocchi G, D'Onofrio R, Branchini M, Lovato L. Unilateral scrotal discomfort in a patient with known renal agenesis: do not forget about Zinner syndrome. BMJ Case Rep 2022; 15:e248468. [PMID: 35064042 PMCID: PMC8785173 DOI: 10.1136/bcr-2021-248468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Guido Marzocchi
- Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola-Malpighi, Bologna, Italy
| | - Renato D'Onofrio
- Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola-Malpighi, Bologna, Italy
| | - Mauro Branchini
- Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola-Malpighi, Bologna, Italy
| | - Luigi Lovato
- Radiology Department, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola-Malpighi, Bologna, Italy
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3
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Militaru V, Mihaly ZA, Ilea C, Coman M, Stanciu M, Crisan N, Coman I. Zinner syndrome - case report. Med Pharm Rep 2021; 94:S47-S50. [PMID: 34527910 DOI: 10.15386/mpr-2229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We present the case of a 51-year-old male with Zinner syndrome, which is a rare disease, resulting from an abnormal evolution of the mesonephric (Wolffian) duct. It consists in cystic dilations of one seminal vesicle and/or ejaculatory duct and ipsilateral renal agenesis. It leads to symptoms related to urination, ejaculation, even infertility, and to low-abdomen and perineal pain. The diagnosis is set by ultrasonography, CT scan and, mainly, MRI. Usually it is treated conservatively, but certain cases require surgery, nowadays minimally invasive.
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Affiliation(s)
- Valentin Militaru
- 5 Medical Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.,Internal Medicine Department, Cluj-Napoca Municipal Hospital, Romania
| | | | - Catalin Ilea
- Emergency Medicine Department, Cluj-Napoca Municipal Hospital, Romania
| | - Mihaela Coman
- Radiology Department, Cluj-Napoca Municipal Hospital, Romania
| | - Mihaela Stanciu
- Radiology Department, Cluj-Napoca Municipal Hospital, Romania
| | - Nicolae Crisan
- Urology Department, Cluj-Napoca Municipal Hospital, Romania.,2 Urology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioan Coman
- 2 Urology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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4
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Karki P, Manandhar S, Kharel A. A rare case of Zinner syndrome: Triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and ejaculatory duct obstruction. Radiol Case Rep 2021; 16:3380-3382. [PMID: 34504629 PMCID: PMC8411213 DOI: 10.1016/j.radcr.2021.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 10/27/2022] Open
Abstract
A rare triad of Wolffian duct anomaly known as Zinner syndrome includes unilateral renal agenesis with ipsilateral seminal vesicle cyst and ejaculatory duct obstruction. It is often diagnosed in third and fourth decades of life. Patient presents with dysuria, perineal pain, infertility and painful ejaculation. The aim of this case report is to show the importance of the radiological imaging on diagnosis of Zinner syndrome. MRI being the modality of the choice for the confirmation of the diagnosis is vital in further management of the syndrome.
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Affiliation(s)
- Prabhat Karki
- Department of Radiology and Imaging, Patan Academy of Health Sciences, P. O. Box 26500, Lalitpur, Nepal
| | - Sagun Manandhar
- Department of Radiology and Imaging, Patan Academy of Health Sciences, P. O. Box 26500, Lalitpur, Nepal
| | - Amrit Kharel
- Department of Radiology and Imaging, Patan Academy of Health Sciences, P. O. Box 26500, Lalitpur, Nepal
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Córdoba Quishpe GA, Sierra Santos L, Maqueda Zamora G, García Morales A. Síndrome de Zinner: monorrenos especiales. REVISTA CLÍNICA DE MEDICINA DE FAMILIA 2021. [DOI: 10.55783/rcmf.140211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Presentamos el caso de un paciente de 13 años, monorreno de nacimiento, asintomático, sin otros antecedentes personales de interés, al que, durante un examen rutinario de su patología de base, se le realiza ecografía abdominal en la que se visualiza un probable quiste ureteral con una dilatación de la vesícula seminal compatible con un probable síndrome de Zinner.
Palabras clave: vesículas seminales, agenesia renal unilateral, anomalías congénitas.
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Affiliation(s)
- Golda Alexandra Córdoba Quishpe
- Residente de tercer año de Medicina Familiar y Comunitaria. Centro de Salud Mar Báltico. Hospital Universitario Ramón y Cajal. Madrid (España)
| | - Lucía Sierra Santos
- Especialista en Medicina Familiar y Comunitaria. Consultorio El Boalo. Madrid (España)
| | - Gloria Maqueda Zamora
- Residente de segundo año de Medicina Familiar y Comunitaria. Consultorio El Boalo. Hospital Universitario La Paz. Madrid (España)
| | - Antonio García Morales
- Residente de tercer año de Medicina Familiar y Comunitaria. Centro de Salud Barajas. Hospital Universitario Ramón y Cajal. Madrid (España)
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6
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Liu Z, Miao C, Zhuang X, Xing J. Zinner syndrome: Cases report and review of the literature. Asian J Surg 2020; 44:523-524. [PMID: 33334643 DOI: 10.1016/j.asjsur.2020.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022] Open
Affiliation(s)
- Zhengsheng Liu
- Department of Urology, The First Affiliated Hospital of Xiamen University, Siming District, Xiamen, Fujian, China.
| | - Chaohao Miao
- Department of Urology, The First Affiliated Hospital of Xiamen University, Siming District, Xiamen, Fujian, China
| | - Xuan Zhuang
- Department of Urology, The First Affiliated Hospital of Xiamen University, Siming District, Xiamen, Fujian, China.
| | - Jinchun Xing
- Department of Urology, The First Affiliated Hospital of Xiamen University, Siming District, Xiamen, Fujian, China.
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7
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Hergan B, Fellner FA, Akbari K. Incidental imaging findings suggesting Zinner syndrome in a young patient with pulmonary embolism: A case report. Radiol Case Rep 2020; 15:437-441. [PMID: 32148603 PMCID: PMC7033301 DOI: 10.1016/j.radcr.2020.01.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/14/2020] [Accepted: 01/20/2020] [Indexed: 11/25/2022] Open
Abstract
A triad of seminal vesical cyst, ipsilateral renal agenesis and ipsilateral ejaculatory duct obstruction is known as Zinner Syndrome. First described in 1914, only about 200 cases have been reported in literature. Usually it stays undiagnosed until the second to third decade of life due to lack of symptoms or nonspecific symptoms such as lower urinary tract symptoms, dysuria or painful ejaculation. In this report we present the case of a 22-year-old patient with a Zinner syndrome as an incidental finding and underlie a review of literature to show the main clinical and imaging implications.
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Affiliation(s)
- Benedikt Hergan
- Central Radiology Institute, Kepler University Hospital, Medical Faculty of the Johannes Kepler University, Krankenhausstrasse 9, Linz, Austria
| | - Franz A Fellner
- Central Radiology Institute, Kepler University Hospital, Medical Faculty of the Johannes Kepler University, Krankenhausstrasse 9, Linz, Austria.,Medical Faculty of the Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Kaveh Akbari
- Central Radiology Institute, Kepler University Hospital, Medical Faculty of the Johannes Kepler University, Krankenhausstrasse 9, Linz, Austria
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Farooqui A, AlDhahir L, Mahfooz AB. Massive seminal vesicle cyst with ipsilateral renal agenesis - Zinner syndrome in a Saudi patient. Urol Ann 2018; 10:333-335. [PMID: 30089996 PMCID: PMC6060597 DOI: 10.4103/ua.ua_17_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Zinner syndrome is a rare male genitourinary tract disorder associated with seminal vesicle cysts and ipsilateral renal agenesis. Clinical presentation often involves symptoms of the genitourinary tract. We present a case report of a young Saudi male, presenting with nonspecific symptoms of fatigue and malaise. Ultrasound visualized a massive seminal vesicle cyst associated with ipsilateral renal agenesis. The cyst was managed using a laparoscopic technique without any immediate complications and an uneventful postoperative period.
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Affiliation(s)
- Azhar Farooqui
- Department of Internal Medicine, Suleiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Loay AlDhahir
- Department of Internal Medicine, Suleiman Al Habib Medical Group, Riyadh, Saudi Arabia
| | - Ali Bin Mahfooz
- Department of Urology, Suleiman Al Habib Medical Group, Riyadh, Saudi Arabia
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Fiaschetti V, Greco L, Giuricin V, De Vivo D, Di Caprera E, Di Trapano R, Castellani F, Floris R. Zinner syndrome diagnosed by magnetic resonance imaging and computed tomography: role of imaging to identify and evaluate the uncommon variation in development of the male genital tract. Radiol Case Rep 2016; 12:54-58. [PMID: 28228879 PMCID: PMC5310246 DOI: 10.1016/j.radcr.2016.10.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 09/26/2016] [Accepted: 10/03/2016] [Indexed: 11/29/2022] Open
Abstract
Seminal vesicle cysts are a very rare condition and its often associated with ipsilateral renal agenesis. The diagnosis of seminal vesicle cysts may be delayed or missed because of the non-specific symptoms of this condition. This article reports a triad of right renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction (Zinner syndrome) in a 56 years old man.
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Affiliation(s)
- V Fiaschetti
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, Fondazione Policlinico "Tor Vergata", viale Oxford 81, Rome 00133, Italy
| | - L Greco
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, Fondazione Policlinico "Tor Vergata", viale Oxford 81, Rome 00133, Italy
| | - V Giuricin
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, Fondazione Policlinico "Tor Vergata", viale Oxford 81, Rome 00133, Italy
| | - D De Vivo
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, Fondazione Policlinico "Tor Vergata", viale Oxford 81, Rome 00133, Italy
| | - E Di Caprera
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, Fondazione Policlinico "Tor Vergata", viale Oxford 81, Rome 00133, Italy
| | - R Di Trapano
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, Fondazione Policlinico "Tor Vergata", viale Oxford 81, Rome 00133, Italy
| | - F Castellani
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, Fondazione Policlinico "Tor Vergata", viale Oxford 81, Rome 00133, Italy
| | - R Floris
- Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiation Therapy, Fondazione Policlinico "Tor Vergata", viale Oxford 81, Rome 00133, Italy
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Canales-Casco N, Dominguez-Amillo A, Arrabal-Polo MA, Sanchez-Tamayo FJ, Arrabal-Martin M, Cozar-Olmo JM. Hematospermia as a Rare Form of Presentation of Zinner Syndrome. Urology 2016; 99:e15-e16. [PMID: 27697459 DOI: 10.1016/j.urology.2016.09.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/14/2016] [Accepted: 09/21/2016] [Indexed: 11/30/2022]
Abstract
A 17-year-old adolescent boy was referred to the urology department of our institution for hematospermia after initiation of sexual relationship. A magnetic resonance imaging scan showed giant dilation of a multicystic left seminal vesicle with left renal agenesis. These findings are typical of the Zinner syndrome. In 70%-80% of the cases when renal agenesis is found, there is an ipsilateral cystic dilation of the seminal vesicle that in some cases may be associated with testicular ectopia or absence of the bladder trigone. The ejaculatory ducts, which are formed from the mesonephric system, are abnormally developed in these cases.
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11
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Management of Zinner's Syndrome Associated with Contralateral Seminal Vesicle Hypoplasia: A Case Report. Case Rep Urol 2013; 2013:494215. [PMID: 23401842 PMCID: PMC3557622 DOI: 10.1155/2013/494215] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 01/01/2013] [Indexed: 11/25/2022] Open
Abstract
A 27-year-old man presented with chronic hematospermia, painful ejaculation, and primary infertility. Physical examination, transrectal ultrasonography, and pelvic magnetic resonance imaging (MRI) demonstrated left seminal vesicle cyst, left renal agenesia, and contralateral seminal vesicle hypoplasia. Hormone workup (LH, FSH, prolactin, and testosterone) was normal. Sperm analysis showed oligoasthenozoospermia and low ejaculate volume. We performed transurethral resection of the ejaculatory duct (TUR-ED) using methylene blue vasography guidance without surgical-related complications. Hematospermia and painful ejaculation completely improved at 2-month followup, and the patient's wife experienced a missed abortion thereafter. This patient was considered as a rare variant of Zinner's syndrome and was managed effectively with a less invasive treatment modality (TUR-ED).
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