Clinical presentation: A 78-year-old woman was referred for an evaluation of a nodule discovered by cardiological examination.

Palpation: a firm nodule in the left lobe.

Hormonal examination indicated euthyroidism with TSH 1.02 mIU/L.

Ultrasonography revealed a solitary hypoechogenic nodule in the left lobe with eggshell calcification and a type 3 vascular pattern, i.e. increased intranodular blood flow.

FNA report was follicular tumor with greater than the average risk of malignancy.

Histopathology disclosed minimally invasive follicular cancer.