The Hidden Triad: Decoding Zinner Syndrome Through Computed Tomography Urography and Magnetic Resonance Imaging

Zinner syndrome is an uncommon congenital anomaly involving the triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction. It is often asymptomatic until puberty or adulthood, when patients may present with genitourinary complaints. We report the case of a 17-year-old male presenting with mild suprapubic discomfort and occasional right testicular pain. Clinical examination was unremarkable. Computed tomography (CT) urography revealed right renal agenesis with a large paravesical cystic lesion. Magnetic resonance imaging (MRI) of the pelvis confirmed a tubular, hyperintense cystic structure adjacent to the prostate and seminal vesicle, containing incomplete septations. These findings were consistent with a seminal vesicle cyst, confirming the diagnosis of Zinner syndrome. Radiological imaging - particularly MRI and CT urography - plays a pivotal role in accurate diagnosis and preoperative assessment. Awareness of this condition and its imaging features is essential for timely identification and management.