Synchronous RCC with multiple myeloma: vertebral lesion mandates evaluation not assumption!

Vertebral lesions in patients with Renal Cell Carcinoma (RCC) are usually assumed to be metastatic. Synchronous malignancies are a rare occurrence. Association between Multiple myeloma (MM) and RCC has been described in the past. Common risk factors and similar cytokine growth requirements could be the linking factors. Here, we describe a patient who had RCC and on evaluation of the vertebral lesion, was found to have Multiple myeloma. We would like to highlight the fact that not all vertebral lesions in RCC are metastatic. Appropriate evaluation for the vertebral lesion would provide holistic treatment in such patients and improve outcomes.