a: PATIENT NO, 64 (continued) The EKG was within normal limits. Stools were negative for ova and parasites. Roentgenograms of the chest and bones for metastasis were negative. Hospital Course: Her hospital course was uneventful. Surgery at New England Baptist Hospital, Boston, Massachusetts: The patient was transferred to the Baptist Hospital in Boston on July 5, 1965, and the following day under general anesthesia the neck was explored by Dr. Bentley P. Colcock. The thyroid nodule was found to be malignant, and he performed a subtotal thyroidectomy leaving a small portion of the left lobe intact. Microscopic study of the tissues gave the following pathologic diagnosis; ''Mixed papillary and ~ follicular carcinoma of the right lobe with blood vessel invasion and metastasis to one lymph node. Negative parathyroid (right). Left lobe of thyroid shows no significant changes." Aside from mild postoperative nausea and vomiting, she recovered very rapidly from the operation. In_view of the positive diagnosis of malignancy, on July 15 she was given 30 mc 13ly in order to ablate the remainder of the thyroid gland and any possible residual metastatic foci. She was returned to this hospital on July 16, 1965. She remained in good health wa and was discharged on July 18, fit for travel back to the Marshall Islands. Diagnosis: Mixed papillary and follicular carcinoma of the right lobe of the thyroid gland with blood vessel invasion and metastasis to one lymph node. Discharge Medication: On August 1 she is to begin taking desiccated thyroid, 120 mg daily. She is to remain under the direct supervision of one of the Marshallese practitioners on her return. Follow-Up: Patient has apparently maintained "euthyroid status" on 3 mg of levothyroxine daily. In March, 1966, she was to have a complete hospital checkup at Tripler Army Hospital in Hawaii but was found to be 5 months pregnant, and the examination was delayed until after birth of her baby. In September, 1966, at Tripler General Hospital, Hawaii, thyroid uptake studies following TSH stimulation (10 units daily for two days), thyroid scans, and skeletal surveys for metastasis showed absence of the thyroid and no detectable metastasis. PATIENT NO. 33 AGE 13 SEX F HOSPITAL Hospital of Medical Research Center, BNL DATE June, 1966 This 13 year old Marshallese girl was admitted to evaluate a thyroid nodule which was discovered during the past year. History of Present Illness: The patient was 1 year old at time of exposure to fallout and received about 175 rads of gamma radiation, radiation of the skin from fallout deposited thereon and some internal absorption of radioisotopes. It was estimated that her thyroid gland received 700-1,400 rads from the radioiodines absorbed in addition to the 175 rads of gamma radiation. Acute effects of her exposure consisted of beta burns of the skin and extensive epilation of the scalp. She also developed transient leukopenia and thrombocytopenia. By one year she had recovered from these acute effects and remained generally in good health. Her growth and development has been about normal with menarche occurring at age 13. In September, 1965, she was thought to have an irregularity of the thyroid gland, 103