Clinical data: A 57-year-old woman was referred for evaluation of a newly diagnosed hypothyroidism. The patient initiated the checkup because of 'lump in the throat' feeling.

Palpation: Both lobes were firm.

Laboratory tests: TSH 12.8 mIU/L.

Ultrasonography: The thyroid was hypoechogenic. A distinct lesion was detected which was located lower to the lower pole of the right lobe.

Aspiration cytology benign lesion. Wash-out thyroglobulin level was 0 ng/mL while wash-out parathormone level was above 474 pg/mL.

Additional laboratory tests: calcium 2.29 mM/L, phosphorus 1.08 mM/L, parathormone 22.5 pg/mL (normal range: 10-65).

Final diagnosis: hypothyroidism caused by Hashimoto's thyroiditis. Benign parathyroid lesion.