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Milk-of-Calcium Renal Stone in Primary Hyperparathyroidism

Ann Intern Med. 1969;70(3):577-580. doi:10.7326/0003-4819-70-3-577
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A woman with a roentgenographic opacity in the right kidney shown to be milk-of-calcium renal stone was diagnosed as having primary hyperparathyroidism, confirmed by surgical removal of a chief-cell adenoma.

Milk-of-calcium renal stone is a suspension of calcium salts layered at the bottom of a renal calyceal diverticulum or a cyst. The pathognomonic sign distinguishing it from a true renal calculus is the fluid level seen on the upright or decubitus films. Awareness of this rare entity may spare the patient nephrolithotomy since percutaneous aspiration may be sufficient therapy. The cause of renal milk-of-calcium is unknown. No previous reports have noted an association between it and primary hyperparathyroidism.





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