CASE 895 Published on 25.02.2001

Seminal Vesicle Cyst

Section

Uroradiology & genital male imaging

Case Type

Clinical Cases

Authors

Y.H.L. Nackaerts, A.M. De Scheper

Patient

37 years, male

Categories
No Area of Interest ; Imaging Technique CT
Clinical History
Dysuria, perineal distress and painful ejaculation. History of chronic recurrent epididymitis.
Imaging Findings
The patient consulted his physician for dysuria, perineal distress and painful ejaculation. He had been treated previously for chronic recurrent epididymitis. Rectal palpation revealed a fluctuating mass in the prostatic area. There was no fever. Laboratory tests were within normal range. CT scan of the pelvis was performed.
Discussion
Aberrations of the distal Wolffian ducts often lead to atresia or stenosis of the ejaculatory ducts, resulting in obstruction and congenital seminal vesicle cyst formation. Congenital seminal vesicle cysts may be associated with ipsilateral renal abnormalities, such as agenesis, dysplasia or hypoplasia. In the absence of associated renal anomalies differentiation between congenital and acquired vesical cysts is not possible. Cysts rarely have a diameter of more than 5 cm, but sizes exceeding 12 cm have been reported. The content of the cyst is a viscous, brownish fluid, containing sperm and blood decay. The cyst wall is thickened and sometimes calcified. Seminal vesicle cysts become symptomatic in the third or fourth decade of life. The possible symptoms include pain (abdominal, pelvic, perineal), dysuria, painful ejaculation, chronic recurrent epididymitis or prostatitis, and occasionally infertility. Infection of the cyst is a frequent complication. Malignant degeneration has not been reported. Differential diagnosis of cystic lesions in this area include bladder or ureteral diverticulum and seminal vesicle abscess. Müllerian duct cysts, cystadenoma of the seminal vesicle or of the prostate, dermoid cysts, teratoma, and echinococcus cysts are less likely to occur but have not to be ruled out.
Differential Diagnosis List
Seminal vesicle cyst
Final Diagnosis
Seminal vesicle cyst
Case information
URL: https://eurorad.org/case/895
DOI: 10.1594/EURORAD/CASE.895
ISSN: 1563-4086