Zinner Syndrome: A Radiological Case Report with Multimodal Imaging Insights

Background: Zinner Syndrome is a rare congenital condition of the male urogenital tract, defined by unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction, resulting from mesonephric duct maldevelopment.  Case Presentation: A 27-year-old male presented with urinary frequency, dysuria, painful ejaculation, and secondary infertility. His history included recurrent urinary tract infections and a solitary kidney. Physical examination revealed a retrovesical mass.  Imaging Findings: Transabdominal ultrasound identified a 5.5-cm left seminal vesicle cyst and absent left kidney. CT urogram confirmed renal agenesis and a non-enhancing retrovesical cyst. Pelvic MRI demonstrated a T1-hyperintense, T2-intermediate cyst with hemorrhagic contents, ejaculatory duct obstruction, and associated prostatitis.  Conclusion: Multimodal imaging, particularly MRI, is essential for diagnosing Zinner Syndrome in young males with urogenital symptoms or infertility. Accurate radiological assessment guides management, ranging from conservative surveillance to surgical intervention.