Clinical presentation: A 58-year-old woman requested a second opinion. She was known to harbor a multinodular goiter for decades. The goiter slowly increased in size and already caused neck complaints in supine position. She wished to undergo on sclerotherapy instead of surgery.

Palpation: The left lobe was enlarged and contained a larger elastic nodule in the upper while a hard, smaller lesion in the lower part.

Functional state: euthyroidism (TSH 1.05 mIU/L).

Ultrasonography. The right lobe was intact. There was a mixed nodule in the upper part of the left lobe. There was another nodule in the middle-lower part of the left lobe. The latter presented the so-called eggshell calcification. Both nodules displayed no vascularization.

Cytology was performed from the nodule with eggshell calcification. Cytological diagnosis: benign, colloid goiter with oxyphilic metaplasia.

A nodule with eggshell calcification is unsuitable for ethanol sclerotherapy because we cannot see anything behind the coarse calcification. Surgery was advised and a left lobectomy was performed.

Histopathology disclosed benign hyperplastic nodules with degenerative changes.

Comment. The extent of spongiform areas is greater than 50%. Whether this nodule can be called spongiform depends on which definition we consider; is it enough to exceed 50% or is it required to be the entire nodule spongiform.