International Journal of Myeloma
Online ISSN : 2187-3143
Volume 9, Issue 3
Displaying 1-1 of 1 articles from this issue
CASE REPORT
  • Tatsuzo MISHINA, Nagisa OSHIMA-HASEGAWA, Shokichi TSUKAMOTO, Yurie NAG ...
    Article type: CASE REPORT
    2019 Volume 9 Issue 3 Pages 19-23
    Published: 2019
    Released on J-STAGE: July 06, 2022
    JOURNAL FREE ACCESS

    POEMS syndrome is a rare multisystemic disease related to monoclonal plasma cell proliferative disorder. Bone lesions in POEMS syndrome are usually sclerotic, and osteolytic lesions are uncommon. Although high-dose chemotherapy administration, followed by autologous stem cell transplantation (auto-SCT) is widely indicated for POEMS syndrome, the pathogenesis and treatment strategy in patients with osteolytic lesions are still unclear. In this report, we present the rare case of a patient with POEMS syndrome with a large osteolytic lesion who was successfully treated with auto-SCT. A 36-year-old man presenting with edema and difficulty in walking was diagnosed with POEMS syndrome based on peripheral polyneuropathy, hepatosplenomegaly, elevated levels of serum VEGF, and IgA-λ monoclonal protein gammopathy. FDG-PET/CT showed high FDG avidity on a large osteolytic lesion on the right pelvic bone, in addition to multiple osteosclerotic lesions. The patient was administered immunomodulatory drugs and a proteasome inhibitor, and subsequently underwent high-dose chemotherapy, followed by auto-SCT. Post transplantation, his symptoms improved gradually, and FDG avidity on the osteolytic lesion decreased. POEMS syndrome with osteolytic lesions indicates a large tumor burden and could be a more progressive disease. For long-term disease remission of POEMS syndrome with osteolytic lesions, an FDG-PET/CT-guided decision for treatment is necessary.

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