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Improvement in the Symptoms and VEGF Levels after Resection of an Extrame Dullary Spinal Tumor and Additional Chemotherapy in a Patient with Multiple Myeloma Complicated with POEMS Syndrome

Authors :
Atsushi Arakawa
Nobutaka Hattori
Tatou Iseki
Kazo Kanazawa
Kenya Nishioka
Makoto Sasaki
Hajime Yasuda
Yutaka Tsukune
Norio Komatsu
Mariko Sano
Kazumasa Yokoyama
Source :
Internal Medicine
Publication Year :
2021
Publisher :
Japanese Society of Internal Medicine, 2021.

Abstract

We 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.

Details

ISSN :
13497235 and 09182918
Volume :
60
Database :
OpenAIRE
Journal :
Internal Medicine
Accession number :
edsair.doi.dedup.....cc6d7da969bcabe609c4db7969b15bf3
Full Text :
https://doi.org/10.2169/internalmedicine.6929-20