POEMS Syndrome

POEMS syndrome is defined by the presence of peripheral neuropathy (P), a monoclonal plasma cell disorder (M), and other paraneoplastic features, the most common of which include organomegaly (O), endocrinopathy (E), skin changes (S), edema, effusion, ascites and thrombocytosis. Virtually all patients have either sclerotic bone disease(s) or co-existent Castleman's disease. We report a case of POEMS syndrome who had all the features essential for the diagnosis including sclerotic bone disease but was diagnosed three years after onset of symptoms. He was treated with radiation therapy to the expansile lesion in the rib with significant clinical and radiological improvement.