Clinical presentation: a 61-year-old woman was referred for evaluation of a newly discovered nodule. The nodule was the only positive finding on a PET-CT scan. The patient was operated on ductal invasive breast cancer for 2 years.

Palpation: a hard nodule in the right lobe.

Functional state: euthyroidism (TSH 2.01 mIU/L).

Ultrasonography. The thyroid was echonormal. There was a hyperechogenic nodule in the right lobe. The had irregular borders and presented coarse calcifications and smaller hyperechogenic figures. The nodule presented halo sign while the vascularization was not specific.

Cytology was performed from the nodule in the right lobe and resulted in suspicion of follicular tumor with greater than average risk for carcinoma.

A right lobectomy was performed and histopathology disclosed follicular adenoma. More than 80% of the nodule was calcified.

Comments.

1. The distinction between non-specific granulations and microcalcifications is not always possible.

2. The irregular shape of the nodule and the presence of hyperchromatic cells were the two independent features which increased the risk of malignancy.