re PATIENT NO. 65 (continued) followed two weeks later by the development of marked beta burns of the skin and epilation of the scalp and leukopenia and thrombocytopenia. She had recovered from these effects by one year. Her subsequent medical history revealed no serious illnesses, but the child was thin and appeared to be somewhat retarded in growth and development. Menarche had not yet occurred. She had recurrent impetigo infections of the skin. On discovery of her thyroid nodule in September, 1965, she was placed on thyroid hormone therapy. The nodule did not reduce in size on this therapy and therefore she was brought here for treatment. Until recently she had been thought to be euthyroid with normal PBI and cholesterol levels. However, by March of this year her thyroxine iodine level was down to 1.9 ug%, and she showed increased TSH levels suggestive of a hypofunctioning thyroid gland. Physical Examination: This slender girl appeared younger than her stated age. A lcm thyroid nodule was noted in the lower pole of the right thyroid. No lymphadenopathy was noted. The remainder of the physical examination was essentially negative, except for the presence of a small pilonidal sinus, Laboratory and X-Ray Data: Thyroid Work-Up: Iodine fractionation studies on her plasma revealed thyroxine iodine of 3.5 uwa% (however, she had only been off of thyroid hormone therapy for about two weeks). Her TSH levels were quite elevated (125 mig/ml}. Antithyroglobulin titre was under 1:16. Thyroid scan using "Pc showed a small but apparently normal thyroid. Though FIMT ¢ uptake was normal, the 1327 uptake at 6 hours was somewhat low and Little increase was noted after TSH stimulation. These findings are in conformity with a hypofunctioning gland. A chest plate was negative except for suggestive extrinsic pressure on the right side of the trachea at the level of T-1. Alkaline phosphatase level was elevated (13.0 units). Hospital Course: The patient's hospital course here was uneventful. On June 5 she was transferred to the New England Deaconess Hospital, and on June 6, Dr. Bentley P. Colcock of Lahey Clinic performed thyroid surgery in that hospital. A right subtotal thyroidectomy was performed with removal of the lower right pole of the thyroid as well as a small cyst from the left lobe. The microscopic diagnosis of removed tissues by Dr. W. A. Meissner of the New England Deaconess Hospital was "adenomatous goiter.' She was returned to Brookhaven on June 11, and her recovery from surgery was uneventful. She was placed on desiccated thyroid, 180 mg daily, to be continued indefinitely. The wound healed nicely, and she was asymptomatic. Diagnosis: Adenomatous goiter. Discharge Medication: To continue thyroid hormone therapy indefinitely. This patient was seen in September, 1966, in the Marshall Islands, and she was found to be euthyroid on the hormone treatment,with no complications. 19 3008393