case_images: PMC11635708_01
case_images: TRUS shows (A) complex cyst replacing the right seminal vesicle (orange arrow). (B) Bulky and edematous left seminal vesicle with heteroegenous echotexture and increased vascularity suggestive of vesiculitis (blue arrow). (C) Dilated right more than left vas deferens (black arrow) secondary to ejaculatory duct obstruction. Heterogenous and edematous prostate with periprostatic oedema and increased vascularity suggestive of prostatitis (red arrow). (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
case_images: gr1.jpg
case_images: PMC11635708_01_gr1.jpg
case_images: fig1
case_images: Prostate appeared edematous, showing heterogenous echotexture, periprostatic oedema and increased vascularity due to prostatitis (Fig. 1).
case_images: TAS shows (A) complex cyst replacing the right seminal vesicle and abutting the bladder posterior wall (yellow arrow). (B) absent kidney with empty renal fossa (grey arrow). (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
case_images: gr2.jpg
case_images: PMC11635708_01_gr2.jpg
case_images: fig2
case_images: However, an out of the box follow-up scan with a vigilant and timely abdominal ultrasound beyond the eyes and need of the clinical symptoms was done which incidentally revealed an absent right kidney with compensatory hypertrophy of the left kidney (Fig. 2).
case_images: (A) MRI pelvis T2 axial sequence shows a complex cyst with hemorrhagic fluid levels (red arrow) arising from right seminal vesicle. (B) MRI pelvis T2 coronal sequence shows the same cyst (red arrow). Also shows left seminal vesiculitis with cystic changes (yellow arrow). (C) Coronal T2 MRI of abdomen shows absent right kidney in right renal fossa (grey arrow). (D) Axial STIR MRI pelvis shows edematous prostate with altered hyperintense signal suggestive of prostatitis. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
case_images: gr3.jpg
case_images: PMC11635708_01_gr3.jpg
case_images: fig3
case_images: Also, the prostate appeared heterogeneously hyperintense on T2-weighted sequence with periprostatic oedema and few tiny cystic areas in the periphery with no diffusion restriction suggestive of prostatitis (Fig. 3).
case_images: PMC11635708_02
case_images: TRUS depicts (A) Left seminal vesicle cyst (green arrow). (B) Tubular nature of the seminal vesicle cyst (green arrow). (C) Small blind ending outpouching in the anterior wall of urinary bladder (black arrow). (D) Small volume of prostate for age (orange arrow). Dilated right and left vas deferens (blue arrow). (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
case_images: gr4.jpg
case_images: PMC11635708_02_gr4.jpg
case_images: fig4
case_images: There was associated left renal agenesis (Fig. 4).
case_images: (A, B, C) T2/STIR MR coronal and axial sections of lower abdomen, pelvis show tubulocystic structure arising from left seminal vesicle with blind ending in LIF (yellow arrows). (D) T2/STIR MR coronal section of pelvis shows ectopic rudimentary ureter remnants (grey arrow) at anterior wall of urinary bladder in proximity with the prostate. (E) MR Urogram 3D reconstruction shows the tubulocyst in LIF (green arrow) with absent left kidney (red arrow). (F) H and E at 40X of the tubulocyst shows transitional epithelial lining (black arrow), muscularis layer (blue arrow) and adventia (red arrow) suggestive of an ureter remnant. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
case_images: gr5.jpg
case_images: PMC11635708_02_gr5.jpg
case_images: fig5
case_images: Prostatic hypoplasia & dilated vas deferens were also seen (Fig. 5). Histopathological examination of the tubulocyst from second case revealed transitional epithelial lining, muscularis and adventitia layers suggestive of an ureter remnant (Fig. 5-F).