In response to the questions relating to the lung tumor, the Institute
expressed the following opinion:
and atrophy or possibly hydronephrosis secondary to
radiation-induced ureteral fibrosis. There is no evidence of any of
these changes in the two urologic examinations performed,
namely November 1965 and October 1966. The rapid clinical
We can find no basis for relating the lung tumor to the treatment
which the veteran received for possible residuals of the testicular tumor.
Although roentgen radiation has been directly responsible for sume
tumors (e€.g., skin cancer) we know of no evidence that roentgen
therapy, even in large doses, has been a direct cause of carcinoma of
lung. And, although it is theoretically possible that roentgen therapy
involving the lungs may be indirectly responsible for the development of
carcinoma of lung on the basis of radiation pneumonitis with fibrosis (in
the nature of so-called scar cancer), there is no evidence of radiation
changes in the slides of the resected lower lobe of the teft lung or in the
slides of the left hilar lymph nodes. Neither, according to the records
response to [the Doctor’s] therapy and the later demonstration of
normal kidney function (October 1966) rule out either
radiation-induced fibrosis-atrophy or hydronephrosis secondary to
ureteral obstruction.
4) Fibrosis of the bladder neck causing (fibrous contracture)
could conceivably result from radiation therapy, but:
a. For fibrosis in this region to be secondary to the radiation
therapy it would be necessary to prove the radiation therapy
was indeed given to this region.
submitted, were there at any time foltowing the radiation to the chest
the clinical symptoms or pulmonary roentgenographic findings assuci-
b. A clearer documentation of this clinical impression is
ated with radiation pneumonitis.
The testicular tumor for which right orchidectomy was done in
service (31 May 1944)(slides not submitted) is recorded in the records
as “Embryonal carcinoma with lymphoid stroma (Seminoma)” and as
‘“Seminoma (Malignant teratoma).” Although late metastasis is known to
necessary.
I. What were the cystoscopic findings at
(Dr..... ] made this diagnosis?
the time
2. What were his impressions as to the etiology of the
occur from seminoma, the tumor removed with the lower lobe of the
process?
tumor.
contracture that no evidence of it existed at the subsequent
examination in October 1966? Fibrous contracture implied
left tung, 17-1/2 years after the orchidectomy bears no resemblance
whatever to a seminoma and must be considered an independent primary
In response to the question relating to the genitourinary disorders, the
Institute stated:
a. There is no known or proven relationship between radiation
therapy and prostatic hypertrophy. No documented examples of
radiation therapy causing hypertrophy have been reported.
b. Prostatitis,
pyelonephritis
and
fibrous
contracture
of the
bladder neck could conceivably result from radiation therapy, but:
1) Inflammation induced by radiation is generally acute,
occurring at the time of administration of the radiation therapy.
Chronic inflammation may occur in the healing stages following
tadiation therapy but it is unlikely that chronic inflammation,
radiation induced, would persist for 20 years.
2) The
chronic
prostatitis diagnosed
in October
1966 was
considered by the examining physician to be secondary to
prostate hypertrophy. In addition, no evidence of chronic
prostatitis was found at the time of prior urologic examinationin
November 1965. The available evidence favors absence of
correlation between radiation therapy and chronic prostatitis.
3. What therapy was employed that would so relieve the
fibrosis which could only be relieved by surgical deiatation.
The Institute of Pathology, therefore, concluded that (1) there was no basis
for relating the lung tumor to the roentgen therapy the veteran received for
possible residuals to the testicular tumor; and (2) no cause and effect
relationship between radiation therapy and the clinical diagnosis of
pyelonephritis, prostatic hypertrophy or chronic prostatitis could be
established in this case. And, although a cause and effect relationship between
radiation therapy and fibrous contracture of the bladder neck (clinical
diagnosis) was theoretically possible, it was unlikely in this case due to the long
interval between the time the radiation therapy was given and the time the
clinical symptoms said to be due to fibrous contracture of the bladder neck
appeared.
7
I
Findings of the BVA and Basis for Decision: {n denying service connection the
Board said in pertinent part:
....The medical reasoning set forth in the report of the Armed
Forces Institute of Pathology is Jucid and unequivocal, and reflects the
views of this Board. The Board, therefore, concurs in the medical
findings and conclusionsof the Institute of Pathology.
3) Pyelonephritis occurring this long after radiation would of
necessity be associated with late radiation changes such as fibrosis
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