Peripheral Neuropathy: Clinical Diagnosis of POEMS Syndrome and Treatment with Radiotherapy

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AWY Ng, KK Yuen, SY Tung, SK O

Hong Kong J Radiol 2007;10:66-9

POEMS syndrome is a rare paraneoplastic syndrome of plasma cell dyscrasia. Since this is a potentially fatal and devastating disease, prompt diagnosis and appropriate treatment is essential. This report is of a young woman who presented with peripheral polyneuropathy that was treated as chronic inflammatory demyelinating polyneuropathy for 18 months before a diagnosis of POEMS syndrome was made when endocrinological and dermatological manifestations arose. Due to repeated failure in obtaining histological confirmation from the isolated sclerotic vertebra, the diagnosis was made clinically. External radiotherapy, using the intensity modulating technique, was given to 45 Gy in 25 fractions. The intention of this report is to raise awareness of the clinical recognition of POEMS syndrome and the role of radiotherapy in the treatment.