Clinical presentation: A 57-yr-old woman was referred for evaluation of a nodular goiter. The patient noticed the nodule 6 years ago. She requested an evaluation because of hypertension.

Palpation: a moderately firm nodule in the right lobe.

Laboratory tests: TSH 1.78 mIU/L, aTPO 11 U/mL.

Ultrasonography. The thyroid was echonormal. A dominantly solid and dominantly echonormal, heterogeneous nodule occupied almost the entire right lobe. While the nodule was relatively large, the nodular lobe was only minimally enlarged. The dimensions of the nodule were 29x22x30 mm while those of the lobe were 30x24x51 mm.

Cytology resulted in benign cystic-colloid goiter.

Suggestion: ultrasound in three years.

Comment. In the event of euthyroid patients having benign nodules, not the size of the nodule but the size of the nodular lobe is the important factor in indicating thyroid surgery. In this patient, the volume of the right lobe was 19.2 mL, and the goiter did not cause any complaints.