Clinical presentation: A 51-year-old woman came to a follow-up visit. She has been diagnosed with multinodular goiter for seven years. Cytology was benign.

Palpation: a multinodular without suspicious lesion.

Functional state: euthyroidism (TSH 1.73 mIU/L).

Ultrasonography. The thyroid was echonormal and hand numerous nodules. The nodule in the right side of the isthmus was the only one which increased over the last seven years.

Cytology was performed form the nodule in the isthmus and resulted in benign colloid goiter.

Suggestion: ultrasound in three years.

Comment. It is worth analyzing the nodule in the right lobe which has echogenic granules. These figures are clearly back wall ones caused by posterior cystic enhancement.