Clinical data: A 42-year-old man was referred for evaluation of a thyroid nodule detected on examination performed because of ventricular arrhythmia.

Palpation: The right lobe was very enlarged, and not freely moveable.

Functional state: euthyroidism (TSH 2.11 mIU/L).

Ultrasonography. The right thyroid was composed of a large hypoechogenic nodule. The vascularization was not specific. The left lobe was inhomogeneous.

Cytology resulted in carcinoma - either a less well-differentiated variant of papillary cancer or poorly differentiated inzular carcinoma.

Histopathology disclosed papillary carcinoma with less well-differentiated foci. The tumor reached and infiltrated the capsule of the lobe but did not break through.

Comment. In such large nodules which fill almost an entire lobe, abutting is almost inevitable. Nevertheless, in this case, abutment was found only in the ventral and medial part of the lobe. The capsule of the thyroid is almost never continuous in such large goiters, whether benign or malignant.