Diagnostic Imaging and Conservative Management of Zinner Syndrome in an Adolescent Male: A Case Report

Abstract

Background: Zinner syndrome (ZS) is a rare congenital triad consisting of unilateral renal agenesis, an ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction. While typically diagnosed in the second or third decade of life, it can manifest earlier during late adolescence. Case Presentation: A 17-year-old male presented with intermittent, vague pelvic discomfort and occasional dysuria. Physical examination was unremarkable. Diagnostic Evaluation: Transabdominal ultrasound (US) revealed right renal agenesis and a retrovesical cystic lesion. Magnetic Resonance Imaging (MRI) confirmed right renal agenesis and a cyst arising from the right seminal vesicle, consistent with Zinner syndrome. Management: Due to mild symptoms, a conservative approach was adopted with symptomatic analgesia and counseling. At the one-year follow-up, the patient remained stable with significant relief. Conclusion: Zinner syndrome should be considered in adolescent males with pelvic symptoms and unilateral renal agenesis. MRI is the gold standard for diagnosis. Conservative management with serial imaging is a safe alternative to surgery in minimally symptomatic cases.