Pelvic renal ectopia, an incidental finding

Description

A woman aged 33 years presented with a 2-week history of non-traumatic back pain, progressive bilateral lower limb weakness with paraesthesia and urinary incontinence. She had a background of recurrent urinary tract infection and hypertension.

Clinical examination revealed reduced power bilaterally (grade 3/5) and reduced reflexes but normal tone. She was unable to walk. Abdominal examination was unremarkable and per rectal examination was normal with good anal tone. She was apyrexial with a blood pressure of 132/86 mm Hg and heart rate of 84 bpm. Admission blood tests (including FBC, CRP, U&E, bone profile, magnesium, B12 and folate) were normal. Urine dipstick was also normal.

An urgent whole-spine MRI excluded cord compression. It did however reveal a soft tissue mass in the pelvis anterior to the S1 vertebral body, just left to the midline extending into the presacral space. This was initially thought to be a lymph node mass (

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