• Mariko Sano, Tatou Iseki, Makoto Sasaki, Yutaka Tsukune, Hajime Yasuda, Kazo Kanazawa, Atsushi Arakawa, Kazumasa Yokoyama, Norio Komatsu, Nobutaka Hattori, and Kenya Nishioka.
• Department of Neurology, Juntendo University School of Medicine, Japan.
• Intern. Med. 2021 Jan 1; 60 (22): 3625-3630.

AbstractWe herein report a case of multiple myeloma and polyneuropathy, organomegaly, endocrinopathy, myeloma protein, and skin changes (POEMS) syndrome. The patient experienced exacerbated gait disturbance due to weakness and numbness in the lower limbs. Thoracic magnetic resonance imaging revealed an extramedullary tumor with spinal compression that required surgical resection. Plasmacytoma was diagnosed based on a biopsy. Radiation, betamethasone, and chemotherapy were therefore administered. Surgical removal of extramedullary tumors improved his symptoms, motor conduction velocity, and amplitude of the muscle action potential in the peroneal and tibial nerves, as shown by the nerve conduction study. Surgery also decreased the serum vascular endothelial growth factor levels. The patient required additional chemotherapy due to multiple myeloma and showed better outcomes nine months after discharge. The benefits of some treatments remain controversial due to the small number of patients. However, our findings reveal that an early diagnosis and comprehensive treatment may result in better outcomes in such patients.

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