Sir.—Because the letter "No Link Between Poland Syndrome and Leukemia?" by Gilman and Miller in the February issue of the Journal (1982;136:176) ended with the sentence, "The absence of comparable case reports from outside the United States is also a puzzle," we would like to mention that such a combination was observed in a 6-year-old girl in Turkey in 1977. The absence of a right pectoralis muscle and nipple with brachydactyly and a small left hand were the present abnormalities (Figure). Roentgenograms did not disclose any vertebral abnormalities or other skeletal deformities.
During a six-year period from October 1975 to October 1981, the conditions of 370 children with acute lymphocytic leukemia were diagnosed at Hacettepe Children's Hospital, Ankara, Turkey. The age range of the children was 2 months to 17 years. The previously mentioned 6-year-old girl was the only patient who has this association, which indicates that it has been