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Angiomyolipoma (AML) is a rare benign neoplasm that usually arises in the kidneys, but may rarely originate in sites such as the retroperitoneum, liver and bone. It is characterised by an intimate admixture of blood vessels, smooth muscle and fat. This multiphasic composition allows for its recognition on ultrasound and CT scan examination. Metastases are exceedingly uncommon, and only one other case of metastatic extrarenal AML exists in the literature. Histological variants of AML such as epithelioid angiomyolipoma (EAML) are considered to be locally aggressive. A unique case of an EAML of the retroperitoneum that metastasised to the liver and bone in an 80-year-old woman is described.

Multiple myeloma (MM) associated with renal failure carries a worse prognosis when compared with MM without renal failure. Bortezomib, a reversible proteosome inhibitor, is a new drug indicated for the treatment of refractory or relapsed myeloma. Published data on the use of bortezomib in patients with myeloma and renal failure are few. We report our experience with bortezomib and dexamethasone in 3 previously untreated and 1 relapsed patient with MM and renal failure. All patients achieved rapid improvement in their renal function as measured by serum creatinine levels with only 1–2 cycles of bortezomib (± dexamethasone), 3 of 4 patients had a near complete response and 1 patient had a partial response. The rapid reversal of renal dysfunction with bortezomib (± dexamethasone) treatment may be an effective strategy to prevent end stage renal failure in MM, thereby improving the morbidity and mortality in this otherwise poor prognosis subset of patients with myeloma.

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