Clinical presentation: A 45-year-old woman referred for a follow-up examination of her cyst located in the left lobe. Previous ultrasound examination demonstrated several small discrete areas in both lobes. She had an upper airway infection several weeks prior to the present visit. Her left thyroid has become painful for two weeks. The complaint has decreased gradually but did not resolve completely. She had no fever.

Palpation: the left lobe was tender.

Functional state: euthyroidism with TSH 1.14 mIU/L.

Ultrasonography. Both thyroids were echonormal. There was a deeply hypoechogenic lesion in the ventral part of the lobe presenting microcalcifications and intranodular blood flow. The left lobe contained a cystic and a moderately hypoechogenic nodule.

Cytology was performed from the lesion in the right lobe and from the cyst. The former resulted in papillary carcinoma. 0.8 ml serous fluid was aspirated form the cyst in the left lobe, cytology resulted in non-diagnostic, cystic lesion.

Histopathology disclosed papillary carcinoma in the right nodule while hyperplastic nodules were diagnosed in the left nodule.