Clinical presentation: A 34-year-old woman patient has delivered for six months. Thereafter a post partum thyroiditis has evolved. On evaluation a nodule was found and aspiration cytology resulted in benign lesion in another institute. The endocrinologist had doubts about the cytology and requested another FNA.

Palpation: Both lobes were firm, no nodule was palpable.

Laboratory tests: TSH 26.9 mIU/L, aTPO >1000 U/mL.

Ultrasonography. The thyroid was hypoechogenic. There were several discrete lesions in both lobes. The largest one which was located in the dorsal part of the right lobe presented punctate echogenic granules. The vascularization was increased in the entire thyroid.

Cytology was performed form the lesion in the dorsal part of the right lobe and resulted in papillary carcinoma.

Total thyroidectomy was performed. Histopathology disclosed chronic lymphocytic thyroiditis and two foci of papillary carcinoma, one in the right lobe with a maximal diameter of 20 mm and another one in the left lobe with a maximal diameter of 0.5 mm.