43
Table 25
Thyroid Lesions in Marshallese. December 1974
Group
Rongelap exposed 1173 rads)
Age at
exposure
Est. thyroid
dose, rads
Subjects® with
thyroid lesions
No. subjects
with surgery
“ Subjects® with
malignant lesions
<10
10-18¢
810-1150
335-810
89.5¢17 19)
16.6/2 12)
15
1
3.3(1 19)
3
6.112 33)
>18
All
Ailingnae exposed (69 rads)
<10
10-18
>18
All
in utero exposed
Utink exposed (14 rads)
Rongelap unexposed
<10
10-18
>18
All
335
536¢
275-450
190
135
217e
175 +>
69 +>
60-958
27-60
27
50°
<10
10-18
Likiep unexposed
91/3 3314
34.4(22 64)
33.312 6)
19
If
0.0(071)
0
33.3 (6, 18)
4
36.3 (4/11)
33 3(1°3)
0.0 (0/1)
0.0 (0°58) |
4.8(1/21)
6.4 (3/78)
3.8 (6, 157)
1.6 (1/61)
7.7 (1/13)
4.7(3 64)
3
1
0
0
1
3
+
4.8 (1, 21)
0.6(1 157)
0
1
> 18
All
5.8 (7/120)
4.6 (9/194)
2
3
<10
0.0 (0/31)
0
>10
All
4.7 (5,106)
3.6 (3/137)
0
0
4Dose from 1311, 132], 133], and 135] plus gamma; mean dose extrapolated from calculations?for adults and 3-vear-olds
‘see Section II).
> Based on numberof people exposed, excluding those in utero (numberof cases/total numberin group).
° The thyroid is considered to be fully developed by about age 18.
4QOne additional case of adenoma, found at autopsy, not included here.
* Weighted mean dose.
‘ Pathologists differed as to whetherthis lesion was malignant; it was scored as benign.
* The more energetic, shorter-lived isotopes of iodine contributedless to the total thyroid dose in the Utirik people because the fallout occurred later there. It might be surmised also that the biological effectiveness of the thyroid dose per
rad would be less in the Utirik group.
roid surgery has been carried out on 24 ofthe exposed Rongelap people with removalof varying
amounts of thyroid tissue depending on the extent
of the lesions (20 were subtotal and 4 total thyroidectomies with parathyroidectomyinadvertently in
one of the latter who was thought to have cancer
at the time of surgery). Of these cases, 3 were
found to have carcinoma ofthe thyroid and 21 to
have benignlesions of the thyroid.
The first case of carcinoma ofthe thyroid oc-
curred in a 40-vear-old woman (29 at the time of
exposure} in the heavily exposed group. Theinterval between exposure and diagnosis was 11
vears.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
woman(age6 at exposure). A fourth case of cancer
was found, 14 years after exposure, in a 36-year-old
Utirik woman whohad received considerably less
exposure.23 Three of 196 unexposed Rongelap people have had surgery with removal of benign adenomas. All three were women. Hospital summaries of
cases admitted at BNL are presented in Appendix 10.
1. Gross Appearance
Since the discovery of the first thyroid lesion 9
years after radiation exposure, clinicians particularly interested in the thyroid have participated in
the annual examinations. As a result, anyslight
irregularities discovered by palpation drew special
attention. This high degree of scrutiny and suspicion led to the detection and removalof nodules