PMID- 21553018 OWN - NLM STAT- MEDLINE DCOM- 20111019 LR - 20211020 IS - 1865-3774 (Electronic) IS - 0925-5710 (Linking) VI - 93 IP - 6 DP - 2011 Jun TI - Development of POEMS syndrome after an initial manifestation of solitary plasmacytoma. PG - 815-821 LID - 10.1007/s12185-011-0863-2 [doi] AB - A 44-year-old male was admitted for numbness in the left arm. CT showed a tumor impacting on the spinal cord with an adjacent thoracic vertebral osteosclerotic lesion. The histopathology of the tumor showed diffuse proliferation of atypical plasma cells with expressed vascular endothelial growth factor (VEGF), which is a known etiological factor in POEMS syndrome. Though serum VEGF (sVEGF) level was elevated, a diagnosis of solitary plasmacytoma with an osteosclerotic lesion was made as the patient presented no polyneuropathy, organomegaly, endocrinopathy, or skin changes. The patient experienced muscle weakness of the lower limbs and skin pigmentation/hemangioma one year after irradiation of the osteosclerotic lesion. Laboratory tests revealed hypothyroidism, hyperglycemia, serum monoclonal gammopathy, further elevation of sVEGF, and increased atypical bone marrow plasma cells. CT imaging showed splenomegaly, and a nerve conduction test revealed demyelinating motor peripheral neuropathy. The patient was therefore diagnosed with POEMS syndrome. Plasmacytoma is very rare as an initial manifestation of POEMS syndrome. Patients presenting with plasmacytoma with an osteosclerotic lesion should be carefully observed and evaluated for the expression of sVEGF and development of POEMS syndrome, as most bone plasmacytomas in POEMS syndrome patients are reported to be osteosclerotic. This is to our knowledge the first case of osteosclerotic plasmacytoma that progressed to POEMS syndrome, with an increase of sVEGF. FAU - Shindo, Motohiro AU - Shindo M AD - Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 1-1 Midorigaoka Higashi 2-jo 1-chome, Asahikawa, Hokkaido, 078-8510, Japan. FAU - Sato, Kazuya AU - Sato K AD - Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 1-1 Midorigaoka Higashi 2-jo 1-chome, Asahikawa, Hokkaido, 078-8510, Japan. satofam@asahikawa-med.ac.jp. FAU - Yamamoto, Masayo AU - Yamamoto M AD - Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 1-1 Midorigaoka Higashi 2-jo 1-chome, Asahikawa, Hokkaido, 078-8510, Japan. FAU - Toki, Yasumichi AU - Toki Y AD - Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 1-1 Midorigaoka Higashi 2-jo 1-chome, Asahikawa, Hokkaido, 078-8510, Japan. FAU - Hatayama, Mayumi AU - Hatayama M AD - Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 1-1 Midorigaoka Higashi 2-jo 1-chome, Asahikawa, Hokkaido, 078-8510, Japan. FAU - Ito, Satoshi AU - Ito S AD - Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 1-1 Midorigaoka Higashi 2-jo 1-chome, Asahikawa, Hokkaido, 078-8510, Japan. FAU - Ichiki, Kazuhiko AU - Ichiki K AD - Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 1-1 Midorigaoka Higashi 2-jo 1-chome, Asahikawa, Hokkaido, 078-8510, Japan. FAU - Okamura, Naoka AU - Okamura N AD - Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 1-1 Midorigaoka Higashi 2-jo 1-chome, Asahikawa, Hokkaido, 078-8510, Japan. FAU - Hosoki, Takaaki AU - Hosoki T AD - Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 1-1 Midorigaoka Higashi 2-jo 1-chome, Asahikawa, Hokkaido, 078-8510, Japan. FAU - Ikuta, Katsuya AU - Ikuta K AD - Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 1-1 Midorigaoka Higashi 2-jo 1-chome, Asahikawa, Hokkaido, 078-8510, Japan. FAU - Inamura, Junki AU - Inamura J AD - Asahikawa Kosei Hospital, Asahikawa, Hokkaido, Japan. FAU - Watanabe, Shinji AU - Watanabe S AD - Asahikawa Kosei Hospital, Asahikawa, Hokkaido, Japan. FAU - Torimoto, Yoshihiro AU - Torimoto Y AD - Oncology Center, Asahikawa Medical University Hospital, Asahikawa, Hokkaido, Japan. FAU - Kohgo, Yutaka AU - Kohgo Y AD - Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 1-1 Midorigaoka Higashi 2-jo 1-chome, Asahikawa, Hokkaido, 078-8510, Japan. LA - eng PT - Case Reports PT - Journal Article PT - Review DEP - 20110507 PL - Japan TA - Int J Hematol JT - International journal of hematology JID - 9111627 RN - 0 (Vascular Endothelial Growth Factor A) RN - EC 3.2.2.6 (ADP-ribosyl Cyclase 1) SB - IM MH - ADP-ribosyl Cyclase 1/metabolism MH - Adult MH - Bone Marrow/pathology MH - Epidural Neoplasms/metabolism/pathology MH - Humans MH - Male MH - Osteosclerosis/diagnostic imaging MH - POEMS Syndrome/diagnostic imaging/*etiology/pathology/therapy MH - Peripheral Blood Stem Cell Transplantation MH - Plasmacytoma/*complications/diagnostic imaging/pathology/therapy MH - Radiography MH - Thoracic Vertebrae/pathology MH - Transplantation, Autologous MH - Treatment Outcome MH - Vascular Endothelial Growth Factor A/metabolism EDAT- 2011/05/10 06:00 MHDA- 2011/10/20 06:00 CRDT- 2011/05/10 06:00 PHST- 2010/08/29 00:00 [received] PHST- 2011/04/19 00:00 [accepted] PHST- 2011/04/18 00:00 [revised] PHST- 2011/05/10 06:00 [entrez] PHST- 2011/05/10 06:00 [pubmed] PHST- 2011/10/20 06:00 [medline] AID - 10.1007/s12185-011-0863-2 [pii] AID - 10.1007/s12185-011-0863-2 [doi] PST - ppublish SO - Int J Hematol. 2011 Jun;93(6):815-821. doi: 10.1007/s12185-011-0863-2. Epub 2011 May 7.