Bilateral Milk-of-Calcium Urine and Hydronephrosis

Abstract

Milk-of-calcium urine associated with hydronephrosis is rare, with only 8 unilateral cases reported previously. We report the first case of bilateral occurrence. Upright films are necessary for making the diagnosis. Although previous reports indicate that the involved kidney has little or no function our patient had only slight impairment of renal function. Nephrectomy should not be done without evaluation of renal function, since some function may be preserved by removing the obstruction that is associated with milk-of-calcium urine and hydronephrosis.

Milk of calcium stones: radiological signs and management outcome

“…It consists of a mixture of calcium oxalate, calcium carbonate and calcium phosphate [11]. MOC is reported mainly with calyceal diverticulum or renal cysts and less frequently in the dilated calyces of hydronephrotic kidney [12]. Urinary obstruction and stasis may lead to super-saturation of calcium salts which form calcium microliths but it is not clear in literature, why it does not form stones [4,6].…”

Milk of calcium (MOC) cysts masquerading as renal calculi – a trap for the unwary

“…They are seen in two groups of patients, each with their own characteristic features. The first and the largest group of patients have MOC in a calyceal diverticulum, while the second group have multiple radiodense levels of MOC in the dilated calyces of a hydronephrotic kidney [7]. …”

Milk of Calcium Cyst Mimicking Renal Calculi: a Case Report

“…It has been proposed as a disturbance between the stone forming factors and inhibitors, and it is uncertain whether urine infection plays a definitive role in the milk of calcium formation [3,4]. Milk of calcium cyst is usually asymptomatic and requires no treatment.…”