Milk of calcium renal cyst

Case contributed by Roberto Schubert
Diagnosis certain

Presentation

Known urolithiasis, microhaematuria.

Patient Data

Age: 60 years
Gender: Male
ct

Non-enhancing lesion adjacent to a renal calyx, that mainly shows homogeneously hyperdense attenuation values with some sedimented denser gravel or debris. There is also a small calculus in the lower calyx, best seen on the MIP. 

Case Discussion

Renal milk of calcium cysts are rare. They typically arise in calyceal diverticula and contain a suspension of crystals. Sedimentation of denser material is a typical feature but may be missed after a change of position (as in CT). Treatment is normally not necessary, but they have to be differentiated from calculi within the collecting system 1.

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