DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.067

Pages: 2473-2477

Zinner’s syndrome is a rare congenital malformation of the male genitourinary tract, classically defined by the triad of ipsilateral renal agenesis, seminal vesicle cyst, and ejaculatory duct obstruction. It typically presents with non-specific pelvic symptoms or infertility in early adulthood, and imaging plays a central role in its diagnosis. We report the case of a 23-year-old male presenting with chronic pelvic heaviness in the absence of urinary or systemic symptoms. Ultrasound revealed right renal agenesis and a right pelvic cystic mass. Contrast-enhanced CT confirmed renal agenesis and identified a seminal vesicle cyst. Pelvic MRI demonstrated an atypical signal pattern : T1 hyperintensity and T2 hypointensity, suggesting proteinaceous or hemorrhagic content, without diffusion restriction or enhancement. Based on embryological correlation and MRI findings, Zinner’s syndrome was diagnosed. A fertility evaluation was initiated. This case highlights the diagnostic value of MRI in detecting atypical signal characteristics of seminal vesicle cysts in Zinner’s syndrome. Awareness of such variations is essential to avoid misdiagnosis, guide appropriate clinical management, and assess reproductive implications. This case supports the role of MRI as a decisive tool in identifying complex cystic lesions and preventing unnecessary interventions.