Rongelap 8 HOSPITAL OF THE MEDICAL RESEARCH CENTER, BROOKHAVEN NATIONAL LABORATORY UPTON, NEW YORK 11973 08-42-34 R Area Code 516 YAphank 4-6262 Nan (UNIT NO] DISCHARGE SUMMARY HOSPITAL COURSE: Her Hospital course was uneventful and it was gratifying that in view of the anemia noted in September, her blood picture was now within normal limita and no contraindications to surgery were noted, ‘The patient was given 25 pci 1311 prior to discharge to ensure complete removai of thyroid tissue at surgery in the eventuality of malignancy. ‘She was discharged on 13 November 1972 and transferred to Cleveland Metropolitan General Hospital. At Cleveland Metropolitan General on 14 November 1972, surgery was performed by Dr. Brown Dobyns, At surgery the right lobe of the thyroid was quite nodular with one firm black nodule about 2 cm in diameter in the superior pole, and smaller ones in the remainder of the lobe. The left lobe appeared relatively normal. Complete right lobectomy was performed and a thorough search revealed no lymph nodes in the vicinity of the thyroid gland on either side. Microscopic examination of the excised tissues revealed small area of papillary carcinome™, ‘The remainder of the lobe exhibited miltiple benign adenomatous lesions. Recovery from surgery was uneventful with no complications. By 19 November 1972, the wound was healing nicely and the patient was discharged to return to the Marshall Islands with the interpreter and the other thyroid patient, A summary of her Hospitalization, including surgical and pathological reports, at the Cleveland Metropolitan General Hospital ie attached, FINAL DIAGNOSIS: DISCHARGE MEDICATION: ? Papillary carcinoma of the thyroid. The patient was placed on thyroxin medica- tion (Synthroid) 2.1 mg weekly. Follow-up advice and treatment instructions are being forwarded to the practitioner in charge of her case at che Majuro Hospital in the Marshall Islands, Careful follow-up exams will be carried out on this girl at the time of our annual medical exams and at six month intervals. She will also have periodic exams at a hospital for thorough thyroid studies co rule out extension of her disease. * Purther pathological review of the sections is in progress. - Received: Typed: cfh 12/20/72 12/21/72 Robert A, Conard, M.D. Page 2 of 2 CC. DP ConarP on hdr ONL 720A 121 -