Zinner Syndrome-From Diagnosis to Successful Treatment-A Case Report

Author(s): George Hadjidekov, Anelia Bueva, Julia Dimova, Violeta Groudeva, Blagovesta Angelova, Rumiana Bakalova

A seventeen-year-old boy was admitted and referred for MR evaluation of acute abdominal and pelvic irritation and discomfort, dysuria and severe pain during ejaculation, the latter symptoms coincident with puberty and the onset of sexual activity. Prior ultrasound had revealed findings consistent with a hypoplastic, hydronephrotic, ectopic left kidney and compensatory hypertrophy of the right kidney. The improved tissue resolution and more precise anatomical delineation of the genitourinary tract afforded by MRI revealed the typical triad of Zinner’s syndrome-unilateral renal agenesis, ipsilateral seminal vesical cysts and obstruction of the ejaculatory duct. MRI not only facilitated the final correct diagnosis, but also supported surgical planning and successful treatment-laparoscopic resection of the left seminal vesicle, which led to complete cure, symptomatic relief and restoration of fertility. Knowledge and understanding of the anatomy and embryology of the genitourinary tract is necessary for obtaining the accurate diagnosis by using appropriate imaging modalities.