Clinical presentation: A 66-year-old man was referred for aspiration cytology because of a nodule detected on evaluation of more than 10 kg weight loss.

Palpation: a firm nodule in the left lobe.

Functional state: euthyroidism (TSH 0.91 mIU/L).

Ultrasonography. The thyroid was echonormal. There was a hypoechogenic nodule in the upper lateral part of the right lobe. The nodule presented irregular borders and nonparallel orientation. A large echonormal nodule presenting halo sign occupied almost the entire left lobe. There was a hypoechogenic area in the medial part of the left lobe.

Cytology was performed from the nodule in the right lobe and resulted in papillary carcinoma.

Histopathology disclosed papillary carcinoma in the right nodule while a follicular adenoma in the left nodule.