Clinical presentation: A 12-yr-old girl was referred for evaluation of a goiter discovered by the school doctor.

Palpation: a very firm nodule in the right lobe.

Laboratory tests: TSH 2.58 mIU/L, FT4 10.0 pM/L, aTPO 145 U/mL.

Ultrasonography. The thyroid was echonormal. There was a hypoechoic nodule in the left lobe. The lesion had microcalcifications and presented both blurred, lobulated and spiculated margins.

Cytology resulted in papillary carcinoma.

Histopathology disclosed papillary carcinoma and Hashimoto's thyroiditis.