PATIENT NO. 64 (continued)
s.
The EKG was within normal limits. Stools were negative for ova and parasite
.
negative
were
is
metastas
for
bones
Roentgenograms of the chest and
Her hospital course was uneventful.
Hospital Course:
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 thyroidMicroscopic study of
ectomy leaving a small portion of the left lobe intact.
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
Aside from mild postoperative nausea and vomiting, she
significant changes."
In_ view of the positive diagnosis
recovered very rapidly from the operation.
of malignancy, on July 15 she was given 30 mc 131r in order to wblate the
remainder of the th: roid gland and any possible residual meta:
.tic foci.
She
was returned to this hospital on July 16, 1965. She remained iv: good health
and was discharged on July 18, fit for travel back to the Marshall Islands.
Mixed papillary and follicular carcinoma of the right lobe of the
Diagnosis:
thyroid gland with blood vessel invasion and metastasis to one lymph nede.
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 falloti 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