Clinical data: The 65-year-old woman was brought in for examination by her daughter. The patient had been on the order for 13 years when we examined a significant size goiter that had been present for 10 years and did not show any growth, according to the patient. The lesion still did not cause a complaint.

Palpation: an extremely enlarged right lobe with multiple nodules.

Laboratory tests: TSH 0.04 mIU/L, FT4 15.2 pM/L, FT3 3.96 pM/L.

Ultrasonography disclosed an extremely enlarged right lobe which had multiple nodules. The lower pole did not come into sight while the patient swallowed. The right lobe had an insignificant hypoechoic lesion. Compared to the dimensions of 13 years ago, no clear change could be seen. However, a goiter of this size cannot be accurately measured by ultrasound.

Neck and upper mediastinal CT. The trachea was dislocated by the lesion but reduced its diameter by only 20%. The lowest pole of the thyroid was 6 cm below the level of the clavicula.

I tried to convince the patient again to undergo surgery.