Zyste des Utriculus prostaticus

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male with excessive post-void dribbling. Lateral image from early in a VCUG exam (left) shows the catheter in a cystic structure that is posterior to the posterior urethra which has a thin line of contrast in it. Lateral image from later in the study during voiding (right) shows the clear communication between the posterior urethra and the cystic structure posterior to it.The diagnosis was prostatic utricle cyst.
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Incidental
findings in and around the prostate on prostate MRI: a pictorial review. Prostatic utricle cyst (a) Axial T2W image shows a high T2 signal pear-shaped cystic lesion (red arrow) in the midline posterior to the prostate (white arrow), and on the sagittal image (b), it can be seen that it does not extend above the base of the prostate in keeping with a utricle cyst
insightsimaging.springeropen.com • CC-by-4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

Prostatic utricle cyst (or utricular cyst) (PUC) is an area of focal dilatation that occurs within the prostatic utricle.

They are midline cystic masses in the male pelvis and can be very difficult or impossible to distinguish from a Mullerian duct cyst.

Epidemiology

Utricle cysts are most often detected in the 1 and 2 decades of life (Mullerian duct cysts usually occur in the 3and 4decades).

The incidence of prostatic utricle cyst ranges around 11-14% in association with hypospadias or intersex anomalies and up to 50% in the presence of perineal hypospadias .

Clinical presentation

Clinical presentation is variable and includes pelvic mass, obstructive and irritative urinary tract symptoms, hematuria, and suprapubic or rectal pain.

Urine may pool in utricle cysts, since they communicate with the urethra, occasionally resulting in post-void dribbling. Some patients may be asymptomatic.

Pathology

Prostatic utricle cysts always arise from the level of the verumontanum and are always in the midline. Mullerian duct cysts can arise anywhere along the path of Mullerian duct regression, from scrotum to utricle.

Utricle cysts are variable in size but are usually smaller (commonly <10 mm) than Mullerian duct cysts and usually do not extend above the prostate gland (Mullerian duct cysts typically extend above the prostate gland).

Associations

Association of prostatic utricle cysts with a variety of genitourinary abnormalities is recognized and include:

Mullerian duct cysts have no such associations .

Radiographic features

MRI

Seen as midline prostatic cyst.

Complications

  • utricle cysts may contain pus or hemorrhage if infected
  • utricle cysts may contain cancer (e.g. clear cell carcinoma, or squamous cell carcinoma) with a reported prevalence as high as 3%

Differential diagnosis

See also

Siehe auch:
Assoziationen und Differentialdiagnosen zu Zyste des Utriculus prostaticus:
Utriculus
prostaticus
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