Clinical presentation: A 49-year-old woman was referred for evaluation of a nodular goiter. Initially, she was examined for gastrointestinal complaints and weight loss.

Palpation: an elastic nodule in the right lobe.

Functional state: euthyroidism (TSH 0.89 mIU/L).

Ultrasonography. The thyroid was echonormal. There was a small, moderately hypoechogenic nodule in the right lobe, while the left lobe contained multiple nodules with different echogenicities.

The moderately hypoechogenic nodule in the lower pole of the right thyroid was aspirated. We gave a combined cytological-ultrasound diagnosis of benign follicular proliferation.

Considering the size of the left lobe we advised a left lobectomy but told the patient that the decision about surgical procedure can be postponed with yearly follow-up examinations.