- POEMS syndrome misdiagnosed as bone metastasis in a patient with thyroid cancer.
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Sang Ah Baek, Hun Mo Ryoo, Sung Hwa Bae, Yoon Young Cho, Seong gyu Kim, Ga Young Kim, Min Keun Kim
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Yeungnam Univ J Med. 2015;32(2):122-126. Published online December 31, 2015
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DOI: https://doi.org/10.12701/yujm.2015.32.2.122
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 Abstract
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- Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome is a monoclonal plasma cell disorder. Patients with POEMS syndrome also have various clinical manifestations including generalized edema, pleural effusion, ascites, papilledema, and sclerotic bone lesions. These manifestations can lead to a misdiagnosis or delayed diagnosis. We recently experienced a 51-year-old male patient with POEMS syndrome whose sclerotic bone lesion was misdiagnosed as malignant bone metastasis of papillary thyroid carcinoma. We reassessed the patient and found polyneuropathy, hepatosplenomegaly, hypothyroidism, partial hypopituitarism, immunoglobulin G lambda-type monoclonal gammopathy, hypertrichosis, ascites, and multiple sclerotic bone lesions, all of which led us to a diagnosis of POEMS syndrome. Treatment with thalidomide and dexamethasone resulted in clinical and radiological improvement. The patient has remained in remission after peripheral blood stem cell transplantation.
- Recurrent thymic carcinoid tumor in familial isolated primary hyperparathyroidism.
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Jeong Eun Song, Mu Hyun Shon, Ga Young Kim, Da Young Lee, Jung Hun Lee, Jong Ho Kim, Ho Sang Shon, Ji Hyun Lee, Eon Ju Jeon, Eui Dal Jung
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Yeungnam Univ J Med. 2014;31(2):131-134. Published online December 31, 2014
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DOI: https://doi.org/10.12701/yujm.2014.31.2.131
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Abstract
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- Familial isolated primary hyperparathyroidism(FIPH) is associated with multiple endocrine neoplasia type 1 (MEN1) syndrome, primary hyperparathyroidism accompanied by jaw-tumor syndrome, and familial hypocalciuric hypercalcemia. FIPH may be an early stage of MEN1 or an allelic variant of MEN1. Thymic carcinoid tumor is a rare tumor in MEN1 syndrome. Here, the authors report the case of a 40-year-old man diagnosed with recurrent thymic carcinoid tumor and FIPH. Both the patient and his elder sister had been previously diagnosed to have FIPH with a novel frameshift mutation in the MEN1 gene. Initially, the patient underwent thymectomy because of an incidental finding of a mediastinal mass in his chest X-ray, and had remained asymptomatic over the following 4 years. Pancreas computed tomography conducted to evaluate MEN1 syndrome revealed anterior and middle mediastinal masses, and resultantly, massive mass excision was performed. Histological findings disclosed atypical carcinoids with infiltrative margins. In view of the thymic carcinoid tumor relapse that occurred in this patient, the authors recommend that regular pancreas and pituitary imaging studies be conducted for FIPH associated with a MEN1 gene mutation.
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Yeungnam University College of Medicine
