poems syndrome is a paraneoplastic manifestation associated with hematopoietic disorders such as multiple myeloma and castleman disease poems is an acronym for the main clinical features of the syndrome namely polyneuropathy organomegaly endocrinopathy m protein and skin abnormalities glomeruloid hemangiomas are considered to be a specific clinical marker of poems syndrome however while they are not pathognomonic their presence should raise suspicion of this syndrome or alert clinicians to its possible future development as these lesions can appear years before the onset of the syndrome we report the cases of 2 women with plasma cell dyscrasias and sudden onset of lesions with a vascular appearance and histologic findings consistent with glomeruloid hemangioma recognition of this vascular tumor is important for the early diagnosis of poems syndrome.