PRIVACY ACT MATERIAL REMOVED out both by palpation of the glands of some of these people, and also their dose of thyroid replacement drugs. Since some who had run out of thyroid replacement medication clinically appeared thryroprivic therefore I feel usually the entire thyroid was removed, a type of surgery commonly performed for thyroid cancer and not a simple benign adenoma. However I understand from several sources that the Brookhaven Institute under the name of Dr. Conard and his associates reports that in the Marshall Islanders there are only very few cancers of the thyroid found, but that almost all of the lesions of the thyroid were benign adenomas. This creates a conflict in my mind, since of the patients, perhaps eighteen to twenty, who had demonstrated to me thyroid scars, one of them was identified histologically as a papillary adenocarcinoma of the thyroid, (in Guam) and this in a relatively young man; and in case of ( he presented an unduly hard nodule in the lowerportion of one of the thyroid lobes, -- so hard, and so well set apart from the thyroid tissue itself, | that I fear this also might be a carcinoma. That radiation would produce so many benign adenomas and so relatively few carcinomas as I am led indirectly to believe is diffi- cult for me to accept. I should, were I involved in further study, like to see sections of all the thyroids removed. One should know that there readily arises an honest difference of opinion that occurs between pathologists as to what constitutes malignancy in thyroid tumors and microscopic re-evaluation will be useful. A second opinion based on microscopic re-evaluation of the tissue is justified by the very high incidence of benign tumors compared with malignant tumors, in face of the known effects of radiation in producing malignancy. There appears to be little doubt that the tumors, benign or malignant, are radiation-induced. There are ‘ just too many of them to be anything else. Otherwise one would have to postulate that the Marshallese had a remarkably high incidence racially of tumors of the thyroid, this existing before 1946, and the old people I spoke to denied this. They denied that prior to the bombs there was any particular epidemic of lumps in the neck. I cannot therefore accept the belief that the Marshall Islanders simply by virtue of their heredity have a tendency toward thyroid tumors. : pracAC MATERIAL REMOVED : wo The other thing that struck me was the frequency of °,