Transcript 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
 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.
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
performed.
and
an
MRI
were
 The
ultrasound found a supraprostatic cyst
formation, lateralized to the left, well
limited, with uniform anechoic content,
measuring 45x40 mm.
 In
addition, renal ultrasound
agenesis of the left kidney.
revealed
Ultrasound shows a supraprostatic cyst
formation, lateralized to the left, well
limited, with uniform anechoic content,
measuring 45x40 mm.



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.




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.
 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.
 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.
 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.