Avoiding the Pitfall: Ectopic Pelvic Kidney Mimicking a Pelvic Mass in a Patient With Recurrent Urinary Tract...

Recurrent urinary tract infections (UTIs) are a common clinical presentation, but they can sometimes be the key signpost to a hidden anatomical surprise. We report the case of a 55-year-old obese woman with a decade-long history of recurrent UTIs and pelvic fullness. Examination revealed a vague pelvic mass, suspicious for a gynecological neoplasm. A contrast-enhanced computed tomography (CT) scan definitively diagnosed an asymptomatic ectopic pelvic kidney, with an empty right renal fossa. The pelvic kidney was the likely anatomical predisposing factor for her recurrent UTIs, which were complicated by antibiotic resistance due to prior self-medication. The case underscores the critical importance of including renal ectopia in the differential diagnosis of a fixed pelvic mass, particularly in patients with recurrent UTIs, to prevent misdiagnosis and iatrogenic injury, and highlights cross-sectional imaging as the essential diagnostic tool.