Milk of calcium in renal cysts: new sonographic features

Abstract

Milk of calcium (MOC) in a small renal cyst or calyceal diverticulum is quite common. Ninety-one small renal cysts with MOC in 61 patients were found within a period of 4 years and 7 months. The main sonographic features are echogenic material layering in the dependent portion of a cyst, associated with reverberation echoes without shadowing. Shadowing was seen when M ilk of calcium (MOC) in a renal cyst or calyceal diverticulum has been considered to be rare 1 • 2 or exceedingly rare, J. and only a few case reportsu -io have appeared in the radiologic and sonographic literature. Traditionally, the reported cysts have been relatively large, characterized by layering of calcium deposits and a resulting acoustic shadow. In our experience, however, small cysts with MOC are quite common. In fact, the ultrasonographic features of MOC in these cysts differ from those reported and consist of layering of the calcium deposits associated with reverberation echoes and with or without shadowing.

Milk of Calcium Cyst Mimicking Renal Calculi: a Case Report

“…Shadowing may be seen in the presence of large amount of milk of calcium. After changing the position of the patient, milk of calcium also changes its position due to gravity [7]. CT findings in supine, prone or lateral decubit positions show the mobile nature of the density and ''half-moon contour'' as illustrated in our case.…”

Rapidly developing renal milk of calcium in a patient with myelomonocytic leukaemia

“…7 Similar to CT scans the echogenic material is seen in the dependent portion of the cyst with reverberation echoes without shadowing. 7 But, shadowing can be seen when larger amounts of renal milk of calcium are present. 7 …”

Renal cyst completely filled with milk of calcium on ct appears as a simple cyst on sonography

“…1,2 Proposed underlying causes for the development of calyceal diverticula include abnormal branching of the ureteric buds and developmental defect of Wolffian ducts. 2,3 Alternative explanations include rupture of renal cyst into the collecting system, as a result of infection, and from passage of a stone. 2,3 The precise mechanism for the development of milk of calcium is not known, but obstruction, stasis, and low-grade inflammation are considered to be key factors.…”

“…2,3 Alternative explanations include rupture of renal cyst into the collecting system, as a result of infection, and from passage of a stone. 2,3 The precise mechanism for the development of milk of calcium is not known, but obstruction, stasis, and low-grade inflammation are considered to be key factors. 3 Reported constituents of milk of calcium include calcium carbonate, calcium oxalate, calcium phosphate, ammonium phosphate, and calcium hydroxyapatite, among others.…”