APPENDIX C THYROID SUMMARY This 35 year old male was 8 months in utero at the time of exposure to the fallout from Bravo. In October 1989 he was noted to have a thyroid nodule in the right thyroid isthmus. He was referred to the NIH for additional evaluation. Physical examination revealed a right sided inferior thyroid nodule approximately 0.8 cm in diameter. The thyroid was of granular consistency and the remainderof within normal limits, including a serum TSH. showeda cold nodule in the lowerpole of the cells were seen. The patient underwent the physical examination was unremarkable. Thyroid function tests were Ultrasound of the neck showed a large nodule. Technetium thallium scan right thyroid. Fine needle aspiration showed blood elements, no follicular a right thyroid lobectomy on 12/7/89. Pathology from the right hemithyroidectomy showed a 6x3x2.5 cm specimen containing a 1 cm hemorrhagic cyst with a 0.5 cm papillary growth within the cyst. Frozen section showed a benign hypertrophic nodule with papillary proliferation and hemorrhage. This was confirmed as a colloid cyst by permanentsection. Two foci of micropapillary carcinoma, separate from the nodule, were detected. The patient was placed on suppressive Synthroid and no additional surgery was performed. Currently the patient is on Synthroid 0.2 mg. q.d. and is doing well. 37