ABSTRACT
You are seeing a 35-year-old, G3P2, Caucasian woman for fetal consultation at 35 weeks of gestation. She has a history of mild Crohn's disease and gastroesophageal reflux. The patient has two healthy children, a 4-year-old girl and a 2-year-old boy, both born by spontaneous vaginal delivery at term. Her current pregnancy has proceeded well. An ultrasound done at 20 weeks of gestation showed a small cystic abdominal mass, approximately 1 cm, adjacent to the bladder in a male fetus. Follow-up ultrasounds demonstrated gradual growth, and the mass now measures 2.3 × 2.2 × 2.2 cm and is located to the right of the bladder. The mass is clearly distinct from the bladder, the gallbladder, and the kidneys. The remainder of the organ survey, as well as the fetal biophysical profile, is normal. There is no sonographic evidence of bowel dilatation, and the amniotic fluid index is normal. The ultrasound images are shown in Figure 32.1.
