Clinical data: a 50-year-old man was referred for an evaluation of difficulties in swallowing. Her complaints evolved over 2 years.

Palpation: a large firm nodule in the left thyroid. The patient did not notice the relatively large lump.

Functional state: euthyroidism (TSH-level 2.63 mIU/L, FT4 16.2).

Ultrasonography: there was a hypoechogenic area with irregular borders in the right lobe. This lesion displayed a type 1 vascular pattern. According to the palpable lesion a moderately hypoechogenic nodule was found in the left lobe. The nodule in the left thyroid displayed microcalcifications and a type 3 vascular pattern.

Cytology: suspicion of papillary cancer, and a benign, colloid goiter, right and left nodule, respectively.

Histopathology: papillary cancer in the right thyroid and an oxyphilic adenoma in the left thyroid. The maximal diameter of the papillary cancer was 4 mm.