Clinical data: A 45-year-old woman was referred for evaluation of a thyroid nodule detected on screening.

Palpation: Both lobes were firm. No nodule could be palpated.

Functional state: euthyroidism (TSH 2.93 mIU/L, anti-TPO 307 U/mL).

Ultrasonography. The thyroid was echonormal and contained discrete hypoechogenic areas. The echogenicity index was around 30%. There was a hypoechogenic nodule presenting fibrosis and microcalcification in the dorsal part of the right lobe. The nodule was surrounded with halo and had perindoular blood flow.

Cytology from the nodule in the right lobe resulted in papillary carcinoma.

Histopathology disclosed papillary carcinoma in the right lobe with a maximal diameter of 9 mm. The tumor caused protrusion of the capsule and spread into the capsule but did not break it through. Hashimoto's thyroiditis was present in the whole thyroid.

Comment.

1. It is advised to analyze the video record. The issue is the presence of microcalcifications.

2. The abutment exceeded 25% and the capsule was discontinuous.