Clinical presentation: a 65-year-old woman was referred for follow-up examination of nodular goiter known for decades. She was first investigated for 30 years. She had occasionally 'lump in the throat' feeling.

Palpation: a nodule was palpable in the lower pole of the enlarged right thyroid.

Functional state: euthyroidism (TSH 0.34 mIU/L).

Ultrasonography. The thyroid was echonormal and contained numerous, similar hypoechogenic nodules. It was equivocal whether the largest one was located in the lower-dorsal part of the right thyroid or outside the thyroid.

Cytological diagnosis: benign lesion.

Wash-out thyroglobulin was > 476 pg/mL while that of parathormone was 1.5 pg/mL.

Comment. On the location of the nodule a parathyroid lesion had to be considered. Nevertheless, the size of the nodule was much larger than a usual parathyroid adenoma and the presence of multiple intrathyroidal lesions with similar echo pattern argued against a parathyroid origin.