Figure 31. ‘Two proliferative papillacy adenomata that were Comaidered benign on the basa of hisidlogical exainination (40, sulaject Na, 63, 196t), Ocber ninute ade. nurmata fram the saaie subject are shown in Figure 33.0. 41 sisting of a solid cellular pattern. Both lesions were accompanied by metastases in the cervical region, In one (Figure $5.4) the cervical metastases were extensive aldhough the primary lesign was ccla- dvely sanall, A total Uivroidcctoimy and uititateral radical cervical lanph-node and upper anterior and posterior meciastios! dissection were pore forined it this case, and there has been uo evi- deace of recurrence ind vears, Vhe second case (HB) was alse treated by total thyroidectomy and regionul Wonpheaale discction, Only a single Iinpl ade adjueent tothe tbvreid coutained IneLastabie tumor although bavasion ty contiguous hla vessels was noted, Vhis subject has remained free of recurrent disease for 10 years. Vhe third madignant lesion (OC) was a follicular adenovarcinama which showed considerable infil- tration af adjacent wormal discoid tissue but was contined to the region of one superior pole and was net accompanied by positive lvinph nodes. A total thyroidectomy with regional lyinph-sode disscetion was done. The regional boinph nodes did not contain metastases, Phere has been no evidence of recurrenve ind vears. The above $ patients with carcinoma were from Rongelap, where the exposure te Gallawat was vretend, The fourth carcinoma (22) was a relatively ues diflercntiated adenocarcinoma — 2.9 coin dian. eter. Jaimany arcas a was solid cellular in charac: tee. Phe pleamarphie cells had breeched the cap. sule iamany phices. The quiaor was observed in vascular spaces but notin lymph nodes, and no distant metastases could be identified. Phe patient had presumably received tininial radiation expo- sure an Uiiik, an outlving ishind quite remote eye Hedin nt Fea A noe Figure Jl. A: A histologic preparations of at lesiana thiot developed in an irradiated Miacslallese thyroiuk (9 14). #: Autoradioyraph, show rag area of sagnilicagt © ap. toke tebe anthe “normal” eatranedulac tieue, ii bord upper corners of the section, and ne uptake in the reo. plasin (dilluse stippling i background). This teion was hot cosmidered malignant. (Same subject an Figure 41.)