CTICasesCaseous (Milk of Calcium) Calcification of the Mitral Annulus
Imaging findings
In a kidney transplant patient with renal failure, CT shows remarkable calcification within the heart, most along the papillary muscle apparatus with milk-of-calcium contents, along with lesser calcification along the mitral annulus.
Key takeaways
This represents caseous, or milk-of-calcium, degeneration of mitral annular calcification, an uncommon but recognized tumefactive pattern of dystrophic calcification that can occur in the setting of chronic renal failure and abnormal calcium handling; the extensive papillary muscle involvement seen here was unusually striking compared with the more typical punctate papillary muscle calcifications commonly encountered.
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