OBJECTIVE: To describe the first reported case of a patient with POEMS syndrome 
(polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin 
changes) in conjunction with the endocrinologic manifestation of 
panhypopituitarism due to a large clinically nonfunctioning pituitary adenoma.
METHODS: We present the clinical, laboratory, and radiologic details of the case 
and review the relevant updated literature.
RESULTS: A 48-year-old man with hypopituitarism and progressive polyneuropathy 
presented to an outside hospital with confusion and diaphoresis. He also had 
diffuse lymphadenopathy, monoclonal gammopathy, and skin lesions consistent with 
a diagnosis of POEMS syndrome. Cytopathologic study of a lymph node showed 
findings consistent with Castleman disease. A large suprasellar mass was found 
to be the cause of the hypopituitarism.
CONCLUSION: POEMS syndrome is a rare paraneoplastic condition, commonly 
associated with Castleman disease, that manifests with progressive distal 
polyneuropathy and a monoclonal plasma cell disorder, often accompanied by 
endocrinopathy, organomegaly, skin changes, sclerotic bone lesions, ascites, 
erythrocytosis, and thrombocytosis. Our current patient had all 5 classic 
features of POEMS syndrome along with some diagnostic elements of Castleman 
disease, sclerotic bone lesions, and thrombocytosis. To our knowledge, this is 
the first known reported case of a patient whose endocrinologic manifestation of 
POEMS syndrome was panhypopituitarism attributable to a large clinically 
nonfunctioning pituitary adenoma.