| Development of POEMS syndrome after an initial manifestation of solitary plasmacytoma. | |
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MedLine Citation:
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PMID: 21553018 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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. |
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Authors:
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Motohiro Shindo; Kazuya Sato; Masayo Yamamoto; Yasumichi Toki; Mayumi Hatayama; Satoshi Ito; Kazuhiko Ichiki; Naoka Okamura; Takaaki Hosoki; Katsuya Ikuta; Junki Inamura; Shinji Watanabe; Yoshihiro Torimoto; Yutaka Kohgo |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-5-7 |
Journal Detail:
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Title: International journal of hematology Volume: - ISSN: 1865-3774 ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-5-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9111627 Medline TA: Int J Hematol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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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. |
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