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 and an MRI were performed.

 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.

 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.

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