Clinical presentation: A 31-year-old woman was referred to evaluation of nodular goiter has been known for several years. The patient noticed a slow increase in nodule size.

Palpation: a firm nodule in the right thyroid.

Functional state: euthyroidism with TSH 2.81 mIU/L.

Ultrasonography. The thyroid was echonormal. There was a minimally hypoechogenic nodule in the right lobe. The lesion contained multiple microcalcifications.

Cytology itself was not reassuring but was not diagnostic of papillary carcinoma.

Combined ultrasound-cytological diagnosis was suspicion of papillary carcinoma.

Histopathology disclosed papillary carcinoma.

Comment. This case illustrates the importance of the team-approach. The cytology itself was itself not enough to raise the suspicion of papillary carcinoma while the ultrasound pattern was highly suspicious.