43 Table 25 Thyroid Lesions in Marshallese, December 1974 Age at exposure Group Rongelap exposed (175 rads} <10 “8 “ Subjects® with thyroid lesions Noa.subjects with surgery % Subjects? with malignant lesions 810-1150 89.5 (17/719) 15 3.3 (1/19) 336 34.4 (22/64) 19 10-18¢ >18 335-810 335 <10 275-430 All Ailingnae exposed (69 rads) Est. thyroid dose, rads 10-18 = ee As Rope In uter, exposed _ ve nL. TSP ean ee vtite we te 6Q+?. UCririkexpaseda4 radt) " <0 ce wy 2. . ( 33.3 (1 *3) ° 0.0 (0,1) 60-935 isi." Veer ee AR ooae Rongelap unexposed OSerOe ee wae TE AR 8 os Be OTR ; aR gO ~ee ae wae Dow el te OR SAMS,xz “Likiep unexppsids egSS Oo eR ates ro - = - ee SIGE 3 4 _- 1 0 6.4 (3/78) 3 1 4.8 (1/21) 3.8 (6/157) 1.6 (1/61) 7.7 (1/13) 4 0 1 0.6 (1/157) 4.6 (9/194) 0.0 (0/31) 3 0 os, as 0 © 4.7 (5/106) an ifr 2 0 5.8 (7/120) - 4.7 (3/64) 0 6.0 (0/38) 4.8 (1/21) 6.1 (2/33) if 0.0 (0'1) on - a8 A2 OB TB l 3 33.3 (26) 190 SE SEs Et Da og see we Neeen a SE Be) 33.3 (6,1 se _ 16.6.(2.12) 9.1 (3. 33)¢ 3.6 (5/137) 2 0 ’ “Doss au,28 18, ahd 158] plus gamma, mean dose extrapolated from calculations®* for adults and 3-year-olds (see Section. bBased ‘on number of'peopleexposetl, excluding those ia ufero (numberof cases/total number in group). ¢The thyroid isconsidered to be fully developed by about age 18. 4QOne additionaj case of adenoma, found at autopsy, not included here. * ¢ Weighted mean dose. " a wi f Pathologists differed adi6 whether this lesion was malignant; it was scored as benign. = ' -& ENBmore energetic : -Bvettinctoper ofiodyne(ohiributed less to the total thyroid dose in the.Utirik peoplehe-.- Pan causethe failoat ocetatredtat “Shere.t rad would be less im wh#Bivteile be pitititvedaise |BhatAbepeingen! efectexcncss of-thethyroiddose per 5.3 lieoe2zeay re os as roid surgery ha’ béen cartied posed Rongelappeopttarith |removalof‘varying v _ wo. oT * . " 2 a : ieso. Saladke tte Rae OR a BBat exposure). Afourthcaseofcancer| -- f amountsof thyreid tissuedependiyonthe-eagent ~ of the lestons (20 were serbsatal atid-4 tot oo ectomies with parathyroidectomy inadvertentlyfin . eh have Sette withremoval ofsees ‘adies. one of the latter who was thoughtto have cancer at the time of surgery). Of these cases, 3 were . oundtohave carcinoma of the.thyroid and 21 to nomas. All three were women. Hospital summaries of cases admitted at BNL are presented in Appendix 10. 1. Gross Appearance “bes ofthe thyroid. .. ofcarcinom=of the thytgid oc-| o “onSince the discovery curred in a40--year-old woman(29 at the time of exposure) in the heavily exposed group. Theinterval between exposure and diagnosis was 11 years.70.23 The second and third cases in this group occurred 15 years after exposure, in a 36-year-old woman (age 21 at exposure) and in a 22-year-old 4a nSE ge years after radiation exposure, clinicians:particu- ~ larly interested in the thyroid have participated in the annual examinations. As a result, any shght irregularities discovered by palpation drew special attention. This high degree of scrutiny and suspicion led to the detection and removal of nodules a