Mullerian duct remnant involving Wolffian system : a case report and literature review

Abstract

14ヵ月男児.患者は繰り返す左精巣上体炎で入院となった.超音波検査では膀胱後部に円形の嚢胞性腫瘤を認め, 排尿時膀胱造影では後部尿道と交通していた.更に内視鏡の結果では, 嚢胞は精阜の中央に尿道との交通を認め, 嚢胞壁の生検では扁平上皮と判明した.以上より, 拡張した前立腺小子宮と診断し, 左精管結紮術を施行した.拡張した前立腺小子宮に精管が開口することは, きわめて稀な病態であると考えられた

A 14-month-old boy with repeated left acute epididymitis was admitted to our department. Ultrasonography detected a midline round cystic mass in a retrovesical region. This was easily opacified by cystourethrography and seen to have a free communication with the posterior urethra. Since urethroscopy revealed a passable orifice in the center of the verumontanum, while a cystic-wall biopsy specimen showed squamous epithelium, we considered this cystic lesion to be an enlarged prostatic utricle. Vasography showed that the bilateral vasa was implanted directly into this cystic lesion, and was the possible cause of his left epididymitis. Ligature of the left vas deferens was performed to prevent left epididymitis. An enlarged prostatic utricle involving the vasa is a rare presentation.