Clinical presentation: A 70-year-old man was referred for evaluation of a nodular goiter detected on carotid Doppler examination.

Palpation: no abnormality.

Functional state: euthyroidism (TSH 1.60 mIU/L).

Ultrasonography. The thyroid was echonormal. There was a hypoechogenic lesion in the ventrolateral part of the right lobe. The lesion presented irregular shape and microcalcifications. Another inhomogeneous nodule was found in the left lobe.

Aspiration cytology was performed from the nodule in the right lobe. Cytology resulted in papillary carcinoma.

Histopathology disclosed papillary carcinoma

Comment. The nodule in the right lobe presents non-pathological blur and spiculated margins, as well.