Journal of Yeungnam Medical Science

영남대 의대 학술지 편집위원회 (Yeungnam University College of Medicine, Yeungnam University Institute Medical Science)
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갑상선암 환자에서 골전이로 오인된 POEMS 증후군

POEMS syndrome misdiagnosed as bone metastasis in a patient with thyroid cancer

  • 백상아 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 류헌모 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 배성화 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 조윤영 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 김성규 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 김가영 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 김민근 (대구가톨릭대학교 의과대학 내과학교실)
  • Baek, Sang Ah (Department of Internal Medicine, Catholic University of Daegu School of Medicine) ;
  • Ryoo, Hun Mo (Department of Internal Medicine, Catholic University of Daegu School of Medicine) ;
  • Bae, Sung Hwa (Department of Internal Medicine, Catholic University of Daegu School of Medicine) ;
  • Cho, Yoon Young (Department of Internal Medicine, Catholic University of Daegu School of Medicine) ;
  • Kim, Seong gyu (Department of Internal Medicine, Catholic University of Daegu School of Medicine) ;
  • Kim, Ga Young (Department of Internal Medicine, Catholic University of Daegu School of Medicine) ;
  • Kim, Min Keun (Department of Internal Medicine, Catholic University of Daegu School of Medicine)
  • 투고 : 2014.06.23
  • 심사 : 2014.08.28
  • 발행 : 2015.12.31
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초록

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.

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