Clinical presentation: A 45-year-old woman requested a second opinion. She was evaluated in another hospital where hypothyroidism was diagnosed on clinical complaints. Ultrasonography described a "suspicious nodule" in the upper pole of the left thyroid from which cytology resulted in suspicion of follicular carcinoma and a total thyroidectomy was indicated.
Palpation: The thyroid was not palpable.
Hormonal examination: hypothyroidism with TSH 23.7 mIU/L.
halo sign and perinodular blood flow