Clinical data: A 20-year-old woman was referred for evaluation of an elevated aTPO: The patient was examined because of dysmenorrhea.

Palpation: Both lobes were a enlarged. No nodule could be palpated.

Laboratory tests: TSH 0.98 mIU/L, aTPO 161 U/mL.

Ultrasonography. The thyroid was minimally/moderately hypoechoic and had some discrete hypoechoic and cystic areas. None of the corresponded to pathological nodule.

Suggestion. TSH in a year, in the event of pregnancy at once.

Comment. The thyroid caused a minimal degree of tracheal compression.