Zinner Syndrome in Adolescence: Imaging Findings

Abstract

Zinner syndrome is a rare congenital anomaly of the mesonephric duct characterised by the triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction. The diagnosis is often made in early adulthood, although many cases remain asymptomatic and are detected incidentally. Imaging plays a crucial role in diagnosis, as clinical manifestations are often nonspecific. Ultrasound is typically the first-line modality, enabling detection of renal agenesis and retrovesical cystic lesions, while magnetic resonance imaging is considered the gold standard for its superior soft-tissue characterisation and multiplanar capability, allowing accurate depiction of seminal vesicle cysts and associated anomalies. We report the case of an asymptomatic 17-year-old male in whom imaging demonstrated right renal agenesis associated with an ipsilateral seminal vesicle cyst and a communicating ureteric remnant, consistent with Zinner syndrome. This case highlights the importance of imaging in recognising the characteristic features of this rare condition.