Clinical data: A 72-year-old man was referred for evaluation of a nodular goiter discovered on carotid Doppler examination.

Palpation: a firm nodule in the right lobe.

Functional state: euthyroidism with TSH 2.07 mIU/L.

Ultrasonography revealed a moderately hypoechogenic nodule with multiple cystic areas. The nodule did not present halo sign but had both perinodular and intranodular blood flow. The hyperechogenic figures corresponded to posterior back wall enhancement.

Cytological report: suspicion of a Hürthle-cell tumor.

Histopathology disclosed Hürthle-cell adenoma.