Clinical presentation: A 52-year-old woman was referred for evaluation of a mass in the neck. The patient was operated on multinodular goiter for 13 years. Total thyroidectomy was performed, and histopathology disclosed benign hyperplastic nodules. She noticed a slowly increasing lump in the left side of the neck for 2 years.

Palpation: multiple nodes next to each other in the left side of the neck.

Result of blood test: euthyroidism on daily 125 microgram levothyroxine (TSH 2.81 mIU/L). 

Ultrasonography. There was no parenchyma in the thyroid beds, connective tissue replaced the thyroid. Lateral and upper to the left thyroid bed, multiple moderately hypoechogenic, inhomogeneous nodules were found next to each other. The largest, longitudinal diameter of the mass was 43 mm.

Aspiration cytology resulted in benign, colloid goiter.

Surgery was performed because of cosmetic reasons.  Histopathology disclosed benign hyperplastic nodular goiter.

Comment. The patient was operated on an experienced thyroid surgeon therefore the probability is minimal that the lesion was already present at the time of surgery.