Should asymptomatic small anteriorly located midline prostatic cyst in young adults be treated surgically or conservatively? A case report and review of the literature

Background Prostatic cysts are uncommon, typically asymptomatic and discovered by chance during imaging. Prostatic cysts in the midline are less prevalent and primarily seen in the posterior aspect of the prostate. Case presentation We describe a case of a 32-year-old man with a complaint of left loin pain and a little sensation of pelvic discomfort. Ultrasound was done revealing small pelvic cystic structure related to urinary bladder base and neck with possibility to be prostatic in origin. Transrectal ultrasound and pelvic magnetic resonance imaging were done and showed an anteriorly located midline prostatic cyst protruding into the bladder lumen, with no communication with the urethra on conventional ascending urethrogram. Conclusion The rare relationship between the cyst, bladder neck, and prostate make this case to some extent unique and further interesting. To our best knowledge, this is the eighth documented case in the literature to describe an anteriorly located midline intraprostatic cyst projecting at the bladder neck and base with illustration of different plans of treatment.