Cystic lesions of the lower male genitourinary tract: a pictorial review and differential diagnosis
Number:27ESURABS0066
Type:Educational Electronic Presentation
Authors: Paulo Santos Correia, João Lopes Dias
Keywords:male pelvis; cystic lesions; magnetic resonance
SECTIONS
Educational objective

- To map and describe the imaging appearance of the most common male pelvis related cystic lesions, with particular emphasis on magnetic resonance.

- To review the main clinical associations and imaging features of their most common differential diagnosis.


Topic Review

Cysts of the lower male genitourinary (CLUT) tract include a wide spectrum of pathologic entities and frequently represent an incidental finding in pelvic magnetic resonance (MR) studies. While some cystic lesions are frequently found on pelvic MR studies, others are very uncommon and may be misdiagnosed.

CLUT are usually benign and asymptomatic. Nevertheless, in some cases, patients may present with clinical symptoms, including hematuria, urinary obstruction or male infertility.

Since most of these lesions are managed conservatively, pathologic correlation is not always possible, and their diagnosis is solely based on imaging appearance, location and eventual clinical features.

MR imaging provides a detailed anatomic assessment of the male pelvis allowing proper localization and classification of these lesions, which are generally easy to identify due to...

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FIGURE 1 - Axial (A), sagittal (B), and coronal (C) T2-weighted MR images show a midline high-signal-intensity teardrop-shaped cyst extending above the prostatic base, featuring a Müllerian duct cyst in an asymptomatic 68 year-old man. Axial (D), sagittal (E), and coronal (F) T2-weighted MR images show a midline high-signal-intensity in an asymptomatic 60 year-old man, featuring a prostatic utricle cyst. Department of Radiology, Hospital de São José, Centro Hospitalar e Universitário de Lisboa Central/ Portugal
FIGURE 2 - Axial (A) T2-weighted MR image show right vas deferens ectasia (arrow). Coronal (B) T2-weighted MR image of patient with right ejaculatory duct ectasia. Hospital de São José, Centro Hospitalar e Universitário de Lisboa Central/ Portugal


Conclusions

Genital-related cystic lesions of the male pelvis include a broad spectrum of entities. Imaging is essential to identify, map and characterize these lesions, as well as their main differential diagnoses.