Clinical data: A 51-year-old woman came to a routine follow-up. She has been followed-up because of a multinodular goiter for more than 17 years. She had no complaints. Scintigraphy disclosed a non-autonomously functioning nodule in the left lobe 6 years ago. TSH was always in the normal range.

Palpation: The left lobe had a not firm nodule.

Laboratory tests: TSH 0.13 mIU/L, FT4 17.5 pM/L.

Ultrasonography. The thyroid were multiple small, isoechoic and minimally hypoechoic nodules in the right lobe. The left lobe had a larger, dominantly solid, echonormal nodule which presented perinodular blood flow. Compared with the study 4 years earlier, the nodule increased from 25x22x28 mm to 29x26x35 mm, width x depth x length, respectively.

Cytology resulted in benign cystic-colloid goiter.

Suggestion: TSH in 6 months, ultrasound in two years.

Comment. It is worth comparing the images got with two setting, i.e. better resolution and better penetrance.