A 16-month-old girl presents to a tertiary care center with a 3-month history of a protruding mass from her vagina. The mass began 3 months ago as a small noticeable nodule in her vagina that rapidly increased in size. The mother states that her daughter has had intermittent white, foul-smelling vaginal discharge with occasional smearing of blood on her diaper. The mother also describes redness of the skin immediately surrounding the mass. The patient has normal urine output and urinary frequency without any evidence of discomfort during urination, and there is no hematuria. There have been no fevers or weight loss, although she has had a decreased appetite for 1 month. The patient initially was evaluated in Mexico by several physicians, who advised her to seek a higher level of care due to the rarity of her presentation. Financial limitations and lack of access to health care after the patient...

You do not currently have access to this content.