Humeral fracture after minimal trauma in 81-year-old man with no known history of malignancy. A, Lesion (arrow) was not identified initially, and patient was treated conservatively at another institution. B, Radiograph 10 weeks after injury shows progression of malignant process. Patient was referred to orthopaedic oncology center, where most likely diagnosis was thought to be either multiple myeloma or metastatic carcinoma. C, Bone scan reveals multiple sites of disease. D, CT of abdomen reveals lesion in the right kidney, which proved to be primary lesion (arrow).