Osteolytic variant of polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes syndrome in a young male – An elusive cause of polyneuropathy

Polyneuropathy, organomegaly, endocrinopathy, M-protein, skin changes (POEMS) syndrome is a rare paraproteinemic paraneoplastic syndrome encountered in the sixth decade with underlying monoclonal plasma cell proliferation and polyneuropathy. The osseous lesions seen are most commonly osteosclerotic. We present a rare case of POEMS syndrome in a 24-year-old patient with osteolytic lesions and fulfillment of the mandatory (monoclonal plasma cell proliferation and polyneuropathy), major (Castleman’s disease on lymph node biopsy), and minor (organomegaly, papilledema) criteria. This case report underlines that the diagnosis of POEMS syndrome should not be discounted in young patients and in the setting of lytic osseous lesions when other diagnostic criteria have been met to mitigate irreversible organ damage.