Mahmoud Hsairi, Achraf Saidi, Ayman El Farouki, Hassane En-Nouali, Rachida Saouab
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 6
Date of Publication: 2026/06/27
Background
Hematospermia is a distressing symptom for patients, although it is most often related to benign or self-limiting conditions. When hematospermia becomes recurrent or persistent, cross-sectional imaging is indicated to exclude structural abnormalities, chronic inflammatory conditions, and neoplastic processes.
Case Presentation
We report the case of a 50-year-old man referred to the urology department for recurrent hematospermia. Physical examination, including digital rectal examination, and laboratory investigations were unremarkable. High-resolution pelvic magnetic resonance imaging (MRI) revealed benign prostatic hyperplasia associated with a well-defined midline cystic lesion located between the seminal vesicles. The lesion demonstrated characteristic MRI findings suggestive of intracystic hemorrhage, including spontaneous hyperintensity on T1-weighted imaging, a T2-weighted "shading" appearance, and thin smooth peripheral wall enhancement after gadolinium administration, without mural nodules.
Conclusion
A hemorrhagic midline cyst of the seminal tract is a rare but recognizable cause of recurrent hematospermia. This case highlights the essential role of MRI in characterizing midline pelvic cystic lesions, excluding malignant features, and providing accurate anatomical mapping to support conservative management.
Hematospermia; Magnetic resonance imaging; Seminal tract cyst; Intracystic hemorrhage; Pelvic MRI
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