A large mullerian duct cyst presenting as an abdominal mass with ipsilateral renal agenesis: an unusual presentation

Symptomatic Mullerian duct cysts are uncommon. A young adult male presented to us with a palpable supra-pubic mass, pain and lower urinary tract symptoms. Initial imaging modalities showed a large cystic lesion in the pelvis with a non-visualized right kidney. A short, blind ending right ureter on retrograde pyelography added to the confusion. On exploration, the lesion was noted to be separate from the seminal vesicles, bladder and posterior urethra. The right kidney was absent. The cystic lesion was excised completely preserving the vas and seminal vesicles. A high index of suspicion is needed for identification of this rare condition. Use of MRI (magnetic resonance imaging) can help improve the diagnostic accuracy. Many a times though, the diagnosis is evident only on exploration.