PATIENT (continued)
and development has appeared to be entirely normal, if not somewhat precocious.
A l em nodule of the left lower pole of the thyroid was noted in September, 1965,
which did not decrease on thyroid hormone therapy.
She appeared to be euthyroid
with PBIs in the normal Marshailese range. Her cholesterol was slightly elevated
in 1957 (277 mg).
Physical Examination:
The patient was obese. The remainder of the physical
examination was essentially negative except for slight acne and dental caries.
Laboratory and X-Ray Data:
Thyroid Studies:
PBI was 7.5 weg% with thyroxin
iodine 4.9 ug%; T3 was 12.9%. Antithyroglobulin titre was 1:32.
Cholesterol
was 162 mg% (esters 151 mg%). Thyroid scan using Pc showed normal uptake
but the gland was asymmetrical, with the right lobe showing uptake only in the

upper portion.

A "hot! nodule was noted in the lower left pole of the thyroid,

1327 uptake was normal and there was normal increase in uptake following TSH
stimulation. The chest plate and EKG were normal. The remainder of the laboratory studies were essentially negative except for an increased sedimentation rate
which is an unexplained finding in most of the Marshallese.
Hospital Course:
Following the studies at this hospital, the patient was transferred to the New England Deaconess Hospital in Boston on June 5, 1966. On
June 8, Dr. Bentley P. Colcock of Lahey Clinic performed a bilateral subtotal
thyroidectomy removing a 1.5 cm nodule in the left lower thyroid lobe and a small
cyst in the right lower lobe.
Dr. W. A. Meissner of the New England Deaconess
Hospital examined the surgical specimens, and his pathological ‘iagnosis was

"adenomatous goiter.''

Recovery from surgery was uneventful, an. the patient was

readmitted ts this hospital on June 11. She was placed on desiccated thyroid,
180 mg daily, indefinitely. Her wound healed nicely, and she was asymptomatic.
Diaznosis:

Adenomatous goiter.

Discharge Medication:

Thyroid hormone therapy to be continued indefinitely.

This patient was seen in September, 1966, in the Marshall Islands, and she
was found to be euthyroid on the hormone therapy, with no complications.

PATIENT NO,

65

AGE

13

SEX

HOS PITAL

DATE

F

Hospital of Medical Research Center, BNL

June, 1966

This 13 year old Marshallese girl was admitted to this hospital for evaluation of
a 0.5 cm nodule of the right lobe of the thyroid gland discovered during the

past year.

.

History of Present Illness:
This child was exposed to fallout radiation in
1954 at 1 year of age and received an estimated dose of 175 rads of whole-body
gamma radiation, irradiation of the skin from deposition of fallout material
thereon, and absorption of significant amounts of radionuclides from ingestion
of contaminated food and water.
It was estimated her thyroid gland received a
dose in the range of 700-1,400 rads from radiotodines in the fallout and in
She had early gastrointestinal symptoms
addition 175 rads from gamma radiation.
108

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