Zinner Syndrome in a Young Male: A Case Report and Review of the Literature

Zinner syndrome is an extremely uncommon congenital anomaly of the male urogenital tract. It is attributed to an embryological anomaly that arises in the distal segment of the mesonephric or Wolffian duct. It is the inadequate migration of the ureteric bud that contributes to the failure of differentiation of the metanephric blastema, which ultimately results in ipsilateral renal agenesis and atresia of the ejaculatory duct. This condition is characterized by a triad of unilateral renal agenesis, ipsilateral seminal vesicle cysts, and ipsilateral obstruction of the ejaculatory duct. In this case report, we describe a 19-year-old male patient who arrived at the general medicine outpatient department with a dull, aching pain in his abdomen and pelvis, accompanied by a feeling of fullness in his pelvis. He had no history of dysuria, hematuria, or ejaculatory pain. The ultrasound scan, computed tomography, and magnetic resonance imaging of the abdomen and pelvis revealed the absence of the right kidney and compensatory hypertrophy of the left kidney. Another well-defined oblong cystic lesion was seen involving the right seminal vesicle without any enhancement in the post-contrast study. Following a discussion regarding the condition of the patient and radiological findings with the urology team, a diagnosis of Zinner syndrome was established. This was subsequently communicated to the patient, who was presented with various treatment options. He expressed a preference to manage his present relatively mild symptoms and opted for follow-up evaluations. The current case report is intended to highlight a very rare case of Zinner syndrome. In addition, a short overview of the scientific literature was taken into consideration with regard to the specifics of the developmental defect, the primary symptoms, the imaging features, and the potential treatment options.