Clinical presentation: A 32-year-old woman was referred for evaluation of thyroid dysfunction. She was treated for a mild hyperthyroidism (FT4 23.5 pM/L) with daily 15 mg methimazole. 7 days after starting with thyrostatics, hypothyroid symptoms have developed (edema, sleeplessness, extreme fatigue). The methimazole was discontinued 17 days before present examination.

Palpation: there was a firm nodule in the ventromedial part of the right thyroid.

Functional state: euthyroidism with TSH 2.98 mIU/L, FT4 13.2 pM/L, FT3 3.95 pM/l, TSAb 0 U/L, anti-TPO 0 U/mL, anti-hTg 3 U/mL.

Ultrasonography. The thyroid was echonormal and had two hypoechoic nodules, one in the right and another in the left lobe. Both lesions had macrocalcifications. The nodule in the right lobe showed taller-than-wide shape and had microcalcifications while the lesion in the left lobe did irregular borders.

Cytology. Papillary cancer was diagnosed in both lobes.

Histopathology. A T1 papillary cancer was found in both nodules.