To the Editor.—
Dr Maldonado and associates (135:267-270, 1975) described three patients with a monoclonal gammopathy and severe osteoporosis resembling multiple myeloma in which no progression to myeloma was observed after three, four, and ten years of observation. This unusual association can be caused by chance alone. However, we have seen recently a patient whose condition fulfilled the criteria of pseudomyeloma and who had an overt myeloma that was observed after 7 1/2 years, which suggests that pseudomyeloma can be the expression of a premyelomatous condition.
A 76-year-old woman was seen in February 1968, with an infiltrating ductal carcinoma of the right breast. She was found also to have a monoclonal spike on serum protein electrophoresis. No Bence Jones protein was demonstrated in the urine. Bone marrow aspiration showed 1% plasma cells and the skeletal roentgenogram disclosed diffuse osteoporosis involving the spine, ribs, and pelvis (Fig 1).