Yeungnam Univ J Med.  2015 Dec;32(2):122-126. 10.12701/yujm.2015.32.2.122.

POEMS syndrome misdiagnosed as bone metastasis in a patient with thyroid cancer

• Baek SA
• Ryoo HM
• Bae SH
• Cho YY
• Kim SG
• Kim GY
• Kim MK

• KMID: 2319913
• DOI: http://doi.org/10.12701/yujm.2015.32.2.122

Abstract

Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome is a monoclonal plasma cell disorder. Patients with POEMS syndrome also have various clinical manifestations including generalized edema, pleural effusion, ascites, papilledema, and sclerotic bone lesions. These manifestations can lead to a misdiagnosis or delayed diagnosis. We recently experienced a 51-year-old male patient with POEMS syndrome whose sclerotic bone lesion was misdiagnosed as malignant bone metastasis of papillary thyroid carcinoma. We reassessed the patient and found polyneuropathy, hepatosplenomegaly, hypothyroidism, partial hypopituitarism, immunoglobulin G lambda-type monoclonal gammopathy, hypertrichosis, ascites, and multiple sclerotic bone lesions, all of which led us to a diagnosis of POEMS syndrome. Treatment with thalidomide and dexamethasone resulted in clinical and radiological improvement. The patient has remained in remission after peripheral blood stem cell transplantation.

Keyword

POEMS syndrome; Papillary thyroid carcinoma

MeSH Terms

Ascites
Delayed Diagnosis
Dexamethasone
Diagnosis
Diagnostic Errors
Edema
Humans
Hypertrichosis
Hypopituitarism
Hypothyroidism
Immunoglobulin G
Male
Middle Aged
Neoplasm Metastasis*
Papilledema
Paraproteinemias
Peripheral Blood Stem Cell Transplantation
Plasma Cells
Pleural Effusion
POEMS Syndrome*
Polyneuropathies
Skin
Thalidomide
Thyroid Gland*
Thyroid Neoplasms*
Dexamethasone
Immunoglobulin G
Thalidomide