Clinical data: A 64-year-old woman came to a routine follow-up. She has been operated on a multinodular goiter for more than 20 years. A total thyroidectomy was performed. A recent thyroid ultrasound resulted in thyroiditis or recurrent nodule.

Palpation: no abnormality.

Laboratory tests: TSH 3.28 mIU/L on daily 100 microgram levothyroxine.

Ultrasonography. Great part of the lobes was composed of hypoechoic mass which showed irregular shape.

Additional test: aTPO 0.5 U/mL.

Suggestion: to continue with daily 100 microgram levothyroxine, TSH in a year.

Comments.

1. Overwhelming majority of the operated thyroids became hypoechoic.

2. This is one of the characteristic presentations of an operated thyroid, a lobe is partly hypoechoic partly echonormal.