B.M. Dobyns and B.A. Hyrmer: Thyroid Neoplasms and Hydrogen Bomb Fallout -e if ir’ om aa are an x Sa oP bree ; : tt. hd co sats ‘ ae ri a Pa Sa’ id Kua,a hee wee nS + HH sf 7 ate Fie al Parahc aioe cj ST ah te Fig. 8. This female was exposed on Rongelap at | year of age. She experienced marked beta burns of the skin, epilation, leukopenia, and thrombocytopenia. A bilateral subtotal thyroidectomy was done at age 12. The diagnosis at that time was adenomatousgoiter. Further surgery was required in [983 for a recurrent growth at age 29. Total left lobectomy (essentially all of the right lobe had been removed atthefirst operation). Diagnosis: Adenomatousgoiter. At the second operation A. two pathologists considered one of the lesions to be mixed papillary and follicular carcinoma(x75). This shows a microfollicular lesion with debatable capsular invasion; however, postoperative scar confusedtheissue in this case. B. High magnification of cells composing the edge of one lesion (x 200). C. A papillary lesion in another part of the lobe with the capsule intact (x75), The early and frequent development of neoplasms in young Rongelap people who were exposed in the early part of thefirst decade oflife is one of the most significant findings in these studies. Such lesions are very uncommonin the general popu- lation of the world; but is dramatically emphasized here by the failure to find masses in control children born after the accident of exposed Rongelap parents. From a knowledgeofthe cultural habits of the Marshallese, it is known that the youngest exposed Marshallese (new born to age 2) were being almost exclusively breast fed. Thus, much of the iodine isotopes passed through the mother via the milk to the tnfant. Upon review of the findings in the mothers of the 6 children who had been exposed in infancy (5 Rongelap; one Utirik} and later were operated for masses, there were 3 of the mothers who havealso been operated, 2 of which had carcinomas. Two of 3 Rongelap children, who were exposed in utero during the first and second trimesters and subsequently were 9). On Utirik where the fallout was much less than on Rongelap, 7 of 8 fetuses of pregnant women exposed are known to have developed no nodules. Benign neoplasms and carcinomas have been found in some of the controls and in some of the Marshallese who presumably had been in the more remote areas (Table 2). What happenedin the fringe areas beyond Utirik is not known; however, later there was detectable radioactivity in some wells on other nearby atolls [3]. The major proportion of radioiodines were short lived isotopes with half lives of seconds to minutes [2]. These caused most of the thyroid damage in people nearest to the point of detonation. The '?'I (half life 8 days) represented only about 1/10th of that of the shorter lived isotopes of iodine in the cloud (2, 9}. Thus, the short lived isotopes had decayed considerably before the cloud had reached the outer limits of known spread. However, the '*'I, although diluted by disper- function to concentrate radioiodine [28]. In the youngerfetus it sion, would not have decayed significantly within the time frame of the drift of the cloud. It is possible that some of the supposedly unexposed people may have received small amounts of attenuated fallout at the fringes of the cloud, although it seems probable that such radiation would have produced minimal, if any, biological effects. operated. In one the lesion was a carcinoma; in the other the of the occurrence of spontaneous neoplasmsin this population andits relationship to the occurrence of neoplasmsin the fringe areas. From time to time efforts were madein this study to find a completely satisfactory group of controls. Even among the operated at ages 19 and 25 respectively, had adenomas with hyperplasia. At least one of these individuals, as a fetus at the time of the accident, should have-developed sufficient thyroidal is Impossible to judge whether thyroidal uptake and retention took place at the time of the accident or lingered in mother’s thyroid long enough to becomeavailable to the maturing fetus. The 2 mothers of the fetuses later developed masses that were Patient was operated twice for multiple atypical adenomas(Fig. The uncertainty through out this study has been the question first group of matched Rongelap controls who were clearly