First examination (1st and 2nd rows of images)

Clinical presentation: A 61-year-old woman underwent bilateral subtotal lobectomy for nodular goiter 15 years ago. She was well. Many hypoechogenic lesions were detected on US screening. These were described as suspicious for papillary cancer.

Ultrasonography: There were five hypoechogenic lesions with hyperechogenic granules within and above the thyroid. These were avascular. Although the US pattern is similar to that seen in papillary cancer, the patient's history is very important.

Cytology: granulations around surgical thread.

Second examination 2 years later (3rd row of images)

Clinical presentation: The patient had no complaints.

Ultrasonography: The sonographic pattern remained unchanged.