Clinical data: An 81-year-old woman has been followed-up for decades. She underwent thyroid surgery at the age of 15 years. I first met her 31 years ago when I felt a 4.5 cm nodule in the right lobe and a 2 cm nodule in the left; I hadn't done an ultrasound yet at that time. Twenty-five years ago, when I first made ultrasound, I described a 38x30x41 mm nodule in the right lobe and two lesion in the left lobe, the dimensions of the larger were 16x10x17 mm. Five years before the present examination, a CT scan was performed for pulmonary reasons. A minimal degree of compression was described. The patient has recently experienced dyspnea, mainly on load.

Palpation: There were not firm nodules in both lobes.

Laboratory tests: TSH 1.94 mIU/L.

Ultrasonography. The right lobe was composed of a larger nodule mass with the dimensions of 39x32x42 mm. The left lobe had two cystic nodules. Compared with the former examiantions, neither nodule has increased in size.

Comments.

1. It is likely that the patient had not only a left but also a right partial lobectomy. The shape of the right lobe speaks for itself. Normally, a lobe is approximately twice as long as it is wide. In this patient, the ratio of the two diameters is close to 1:1.

2. In many cases, a relatively large thyroid lobe or nodule does not grow, or only very slightly, over decades.