Clinical presentation: A 54-year-old woman was referred for aspiration cytology. A multinodular goiter discovered on a routine examination.

Palpation. There was firm nodule in the left lobe.

Functional state: euthyroidism with TSH-level 1.22 mIU/L.

Ultrasonography: The right lobe contained multiple nodules with different echogenicities. There were two nodules in the left lobe. One of them was hypoechogenic with patchy hyperechogenic areas. There was an enlarged lymph node above the left lobe.

Cytological diagnosis: medullary cancer.

Histopathology: medullary cancer in the left lobe with metastasis to the lymph node of the neck, and there were hyperplastic benign nodules in the right lobe.