Clinical presentation: A 42-year-old woman was referred for evaluation of complaints suggesting hyperthyroidism.

Palpation: Both lobes were enlarged.

Laboratory tests: TSH 0.001 mIU/L, FT4 67.1 pM/L.

Ultrasonography. The thyroid was hypoechogenic and presented several more and less hypoechogenic discrete areas which did not correspond to nodules in pathological sense. The vascularization was increased.

Suggestion daily 30 mg methimazole and after restoration of FT4-level, total thyroidectomy.

Histopathology: Diffuse goiter corresponding to Graves' disease.