Clinical presentation: A 61-year-old woman was referred for follow-up evaluation. She has been know harboring an autonomously functioning nodule for almost 20 years. At the time of the diagnosis, the diameters of the nodule were 12, 11 and 13 mm, width, depth, and length, respectively. She has been always euthyroid and had never got any thyroid medication. The nodule had increased slowly but continuously over the decades.

Palpation: a not firm nodule in the right lobe.

Functional state: euthyroidism (TSH 1.70 mIU/L).

Ultrasonography. The thyroid was echonormal. There was a moderately hypoechogenic nodule in the right lobe. The lesion displayed halo sign and perinodular blood flow.

Suggestion: TSH in a year, ultrasound in 3 years.