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SUBJECT : FURTHER INFORMATION ON FOR RRMOVAL OF THYROID MEMO, THIS SUBJECT) . NODULES (SEE ATTACHED COPY OF PREVIOUS h. Robert A. Conard, Medical Department, Brookhaven National Laboratory, who has responsibility for conducting the clinical surveys, reports: “Sections of the nodules have been examined by a number of pathologists concensus is that the nodules are benign, though with certain bizarre areas, and resemble iodine deficiency adenotoata.’t Dr. Lindsay noted that the nodules in the RongeIap cases are similar to ones he has seen in children following I131 therapy. This Division has a file of Dr. Lindsayts histological reports and a review paper by Lindsay and Chaikoff, Cancer Research, 24:1099, 1964. The radiation dosages which these children’s thyroids may have received are being re-evaluated by Dr. John Gofman*s group, Lawrence Radiation It should be added that nodules in the thyroid glands of young people frequently become malignant in the course of time. Therefore, while these which were removed promptly after discovery were not malignant, there is a chance that in time they might have assumed neoplastic characteristics. Dr. Conard’s next clinical survey will take place in Division of Biology and Medicine us IXIE ~~~l13E$emo date 10/2/64
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MEMOMNDUM FOR CHAIRMAN SEABORG SUBJECT : THYROID DISEASE IN RONGELAP ISLANDERS During the February 1964 annual medical survey of the Marshallese Islanders exposed to fallout from the March 1, 1954, shot over Bikini, three young teenagers, 13-14 years old, were found to have nodules in their thyroid glands. The medical team felt that two of them should have immediate thyroidectomies, and these operations were successfully carried out at the Naval Hospital on Guam with the full cooperation of the Trust Territory people and the medical services of the Department of Defense. The pathological diagnoses were papillary adenocarcinoma, a malignant tumor of the thyroid. The prognosis, of course, is uncertain, but the surgeons are reported to have felt that they may have removed all the neoplastic tissue. While this information has not been transmitted formally, it is regarded as reliable. It is planned that a ten Year summary of the health status of the exposed Marshallese, including these recent developments, will be prepared for prompt publication in a prominent journal such as the Journal of the American Medical Preparations are now going ahead to have the third child with a small nodule operated on as soon as possible. The estimated doses to these thyroids are some 100 to 175 rads external gamma plus 100 to 150 rads from absorbed radioiodine.
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Since the spontaneous occurrence of two, and possibly three, cases of thyroid neoplasm among the small number of exposed Marshallese children is most unlikely, these observations till probably give rise to comment in various quarters. For this reason, it seems desirable to consider this matter as tentative until the documented data are in hand. You and the Commission will be informed promptly at that time. Division of Biology and Medicine