Clinical data: An 82-year-old man came to a routine follow-up. He has been known an enlarged multinodular goiter for more than four decades. The goiter never caused him any complaints.

Palpation: The left lobe was enlarged and had multiple, not firm nodules.

Laboratory test: TSH 1.08 mIU/L.

Ultrasonography. The thyroid was echonormal and had numerous nodules. The right lobe was not enlarged, it had an echonormal lesion with irregular lobulated margins. The lower pole of the enlarged left lobe was not visible before swallowing while came into sight during swallowing. Compared with the previous examinations, no progression was found. In fact, the size of the lobes was the same as what I saw at the first encounter, 19 years earlier.

Suggestion: ultrasound in three years, in the event of complaints sooner.

Comment. It is worth watching the video twice. Pay attention once to the nodules in the left lobe, especially the lower one, and the second time to the lower pole that moves due to swallowing.