Martinique

This is a G₁P₀ 30-year-old patient with unremarkable history. Her examination at 22 weeks demonstrated a normal left kidney and multiple small cysts on the right kidney. The bladder appeared unremarkable, and the impression was that the baby had a unilateral multicystic kidney dysplasia.

The postnatal examination confirmed the normal left kidney, and the cysts in the right kidneys. There is also a perineal cystic structure.

However the physical examination of the newborn demonstrated a vulvar mass, posterior to the urethra and anterior to the vagina. 

The intravenous pyelogram and the voiding cystourethrogram demonstrate a normal left collecting system but no opacification of the right kidney.

The perineal mass was incised and fluid similar to urine (and different from secretion from hydrocolpos) was drained. The ostium of the right ureter was in the cyst. Thus the final diagnosis was ectopic ureter with ureterocele in the proximal urethra and renal cystic dysplasia from long standing obstruction.