A 3 year-old Female with Palpable Mass in Vulva

A 3.5 year old female with recurrent urinary tract infections from 6 month ago has been treated with oral antibiotics for a long time. She was admitted in nephrology ward for more evaluations. In physical examination a palpable mass was presented at the vulva (Figure 1). Kidney ultrasound showed normal left kidney (LK=81*33 mm) and elongated, duplicated and hydronephrotic right kidney. The patient underwent intravenous pyelography (IVP), DMSA scintigraphy and voiding cystoureterography (VCUG).