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Pelvis » Scrotum And Testicles
Zinner syndrome
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Author(s) :
S. Manohar, MD, DMRD
Presentation A 32 year old man presented for infertility. Semen analysis revealed oligo-asthenospermia. A scrotal and pelvic scan was performed.
Caption: Scans demonstrating the left testis
Description: This sagittal and transverse view of the left testis reveals no abnormality.
Caption: Comparative scans showing both sides
Description: The right testis and epididymis appear normal. The left epididymal head demonstrates tiny cystic spaces. The left testis appears normal.
Caption: Magnified view of the left scrotal contents
Description: The left epididymal head is noted here showing the tiny clear cystic spaces.
Caption: Color Doppler of the left pampiniform plexus
Description: Resting and Valsalva maneuvers demonstrate a left sided varicocele.
Caption: Color Doppler scans of right pampiniform plexus
Description: Resting and Valsalva maneuvers demonstrate a right sided varicocele as well.
Caption: Transrectal scan-right parasagittal view
Description: This view demonstrates a normal right seminal vesicle. The visualized urinary bladder appears normal.
Caption: Transverse transrectal view
Description: There is non-visualization of the left seminal vesicle, most likely due to agenesis. The right seminal vesicle is normal.
Caption: Transrectal scans of the prostate
Description: A normal sized prostate gland is seen in these views. No intra-prostatic cyst or ejaculatory duct dilatation or calculi are seen.
Differential Diagnosis There are cystic spaces in the left epididymal head which suggest vasal obstruction, vasal agenesis or ejaculatory duct obstruction. The combination of left vasal, left seminal vesicle and left renal agenesis suggests the diagnosis of Zinner syndrome.
Final Diagnosis Zinner syndrome
Follow Up An abdominal ultrasound was performed which showed left renal agenesis as well. All these findings led to the diagnosis of Zinner syndrome.
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