Presentation
Epigastric pain ?perforation.
Patient Data
Age: 35 years
Gender: Female
From the case:
Renal milk of calcium cyst
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_pin":false},"extraPropsURL":"/studies/32335/annotated_viewer_json?lang=us"}
Ill-defined rounded opacity on the supine film projects over the upper pole of the right kidney demonstrates layering on the erect projection.
No evidence of pneumoperitoneum.
From the case:
Renal milk of calcium cyst
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_pin":false},"extraPropsURL":"/studies/32340/annotated_viewer_json?lang=us"}
Ultrasound confirms finding of echogenic structure with dependent echogenic material, consistent with milk of calcium cyst.
From the case:
Renal milk of calcium cyst
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_pin":false},"extraPropsURL":"/studies/32352/annotated_viewer_json?lang=us"}
CT confirms presence of a renal cyst, likely calyceal in origin, with dependent calcification.
Case Discussion
Key learning points:
- typically an incidental finding that does not require further treatment
- most frequently seen in calyceal diverticulae but can also occur in renal cysts
- on abdominal radiographs has a "full moon" appearance on supine projections, which changes "half moon" appearance on erect project
- on ultrasound has dependent echogenic material within a hypoechoic cyst