Polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, 
skin changes (POEMS) syndrome is a rare paraneoplastic disorder. The 
polyneuropathy can be the presenting symptom and is typically a painful, 
motor-predominant polyradiculoneuropathy often mimicking chronic inflammatory 
demyelinating polyradiculoneuropathy. The presence of a lambda monoclonal 
protein, elevated vascular endothelial growth factor, systemic features, and 
treatment resistance are clues to the diagnosis. Castleman disease (CD) is seen 
in a subset of these patients, and when present the neuropathy is similar but 
less severe. In contrast, in those patients with purely CD, the neuropathy is 
often a mild, painless distal sensory neuropathy.