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URINARY: UR16. HEMORRHAGIC CYST OF VAS DEFERENS AMPULLA: A REPORT CASE. L. EL ASSASSE, S. BOUTACHALI, F. AMRAOUI, A. AJANA, L. SBIHI . Radiology service, Avicenne hospital, Rabat, Morocco. Introduction: . The cyst of the vas deferens ampulla is a rare pathology, often of congenital origin.
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HEMORRHAGIC CYST OF VAS DEFERENS AMPULLA: A REPORT CASE L. EL ASSASSE, S. BOUTACHALI, F. AMRAOUI, A. AJANA, L. SBIHI. Radiology service, Avicenne hospital, Rabat, Morocco
Introduction: • The cyst of the vas deferens ampulla is a rare pathology, often of congenital origin. • The hemorrhagic character usually occurs after a trauma. • We report in this work a case of hemorrhagic cyst of the vas deferens ampulla illustrated by ultrasound and MRI.
Observation: • A 29-year-old young man without significant medical or surgical history, presented for last year a pelvic pain reported 2 months after a pelvic trauma. • A pelvic ultrasound and an MRI were performed.
Results and discussion: • The ultrasound found a supraprostatic cyst formation, lateralized to the left, well limited, with uniform anechoic content, measuring 45x40 mm. • In addition, renal ultrasound revealed agenesis of the left kidney.
Ultrasound shows a supraprostatic cyst formation, lateralized to the left, well limited, with uniform anechoic content, measuring 45x40 mm.
Results and discussion: • On MRI: • Presence of a cystic mass roughly rounded, well defined in the left vas deferens ampulla, with hemorrhagic content (homogeneous hyperintense signal on T1 and hypointense on T2), surrounded by a very thin wall, did not enhancing after gadolinium injection. • This mass measuring 44x46x50mm, and its anterior surface comes in contact with the bladder, it pushes back the rectum and laterally seminal vesicles.
Results and discussion: • The left seminal vesicle is repressed by the lesion and also presents a hemorrhagic content. • The ejaculatory duct is slightly dilated with hemmorrhagic signal. • No stones visible in the ejaculatory duct or vas deferens ampulla or in the seminal vesicle. • Absence of utricular or Mullerian cyst.
Sagittal T1 before and after gadolinium injection and T2 MRI: Mass in the left vas deferens ampulla; it presents a hyperintense signal on T1 and hypointense on T2, and is not enhanced after gadolinium injection in favor of hemorrhagic cyst.
Axial T1 before and after gadolinium injection and T2 MRI: Mass in the left vas deferens ampulla; it presents a hyperintense signal on T1 and hypointense on T2, and is not enhanced after gadolinium injection in favor of hemorrhagic cyst.
Results and discussion: • Cysts of urogenital tract are due to defective resorption of Müller or Wolff channels in life in utero. • Renal agenesis is often associated. • Hemorrhagic character may occur following trauma as in our patient.
Conclusion: • Echography in particular endorectal ultrasonography allows the diagnosis of urogenital tract cyst. • However, MRI may be indicated for voluminous cyst which limits and relations are difficult to specify.
REFERENCES: • El Ghazouli N, Amraoui F, Skalli A, Chikhaoui N. Evaluation échographique de l’infertilité masculine. J Maroc Urol 2008; 10: 7-11. • Fisch H, Kang YM, Johnson CW, Goluboff ET. Ejaculatory duct obstruction. Curr Curr Opin Urol 2002; 12: 509-15. • Meacham RB, Townsend RR, Drose JA. Ejaculatory duct obstruction: Diagnosis and treatment with transrectal sonography. AJR 1995; 165: 1463-66.