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The natural history of a “benign” rib lesion in a patient with a demyelinating polyneuropathy and an unusual variant of poems syndrome

✍ Scribed by Dr. Zachary Simmons; Dr. John Wald; Dr. James W. Albers; Dr. Eva L. Feldman


Publisher
John Wiley and Sons
Year
1994
Tongue
English
Weight
510 KB
Volume
17
Category
Article
ISSN
0148-639X

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✦ Synopsis


Abstract

Patients with POEMS (polyneuropathy, organomegaly, endocrinopathy, M‐protein, and skin changes) syndrome exhibit great clinical variability and often have osteosclerotic myeloma. We present a patient with an acquired demyelinating polyneuropathy who was eventually diagnosed as having POEMS syndrome. Her long period of observation permitted documentation of the natural history of a plasmacytoma, including its remarkably slow rate of growth and its transformation from a nonsclerotic to a sclerotic bone lesion. Her clinical and laboratory features emphasize the variability of this syndrome. Biopsy of benignappearing bone lesions should be considered in patients with acquired demyelinating polyneuropathies who do not respond to standard treatment modalities. Serial x‐rays may not distinguish benign lesions from plasmacytomas in this treatable condition. © 1994 John Wiley & Sons, Inc.