Clinical presentation: A 61-year-old man came to a follow-up examination. He has been under follow-up for 8 years when a nodule was discovered by himself. At this time, the dimensions of the left lobe were 27x37x51 mm (width, depth and length, respectively).

Palpation: Both lobes were nodular on palpation, the left lobe was substantially enlarged.

Hormonal evaluation indicated euthyroidism (TSH 1.93 mIU/L).

Ultrasonography. The thyroid was echonormal and had numerous discrete lesions and nodules. The left lobe had several cystic lesions. The dimensions of the left lobe remained unchanged, these were 31x32x58 mm (width, depth and length, respectively).

Suggestion: ultrasound in 2 to 3 years.

Comment. The decision whether to operate a patient on the size depends not on the size of a nodule but the size of the lobe. Therefore, in benign nodular goiter the three dimensions of a lobe are the most important data; these are the basis for the follow-up.