Poems syndrome presenting as plasmacytoma and polyneuropathy

We report a 52 year old woman presented with a solitary plasmacytoma in the left 4

h rib and chronic demyelinating polyneuropathy. Patient had associated lymphadenopathy, hepatosplenomegaly and hyper pigmentation of the skin. Serum electrophoresis and lmmuno fixation revealed M band [lgG, Lambda light chain]. With the above constellation of clinical findings patient was diagnosed to have POEMS syndrome [polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes]. Radiation to the plasmacytoma resulted in significant improvement. Hence we suggest that all patients with cryptogenic polyneuropathy be investigated properly for this potentially treatable condition